With the arrival of Breast Cancer Awareness Month, Comprehensive Cancer Centers reflects upon the progress made in treatment and detection while encouraging women to stay aware about potential risks. Through early detection and by cancer genetic counseling, breast cancer risks can be uncovered sooner than ever before.
According to the American Cancer Society, 2,190 Nevada females will be diagnosed with breast cancer in 2019. This marks a slight increase year after year. Nationally, there has been a gradual, projected rise in new cases as well, with incidence rates increasing by approximately 0.4 percent in recent times. This is due to better detection at earlier stages with improved screening tools such as digital mammography, specialty 3-D mammograms and MRI screening when indicated.
In the past 10 years, death rates have fallen by approximately 1.9 percent per year. This is due not only to earlier detection, but also to improved treatments as provided by the team of oncologists and breast surgeons at Comprehensive Cancer Centers.
Proactive measures are vital in keeping these statistics trending in the right direction and ultimately saving lives. And at the forefront of these measures is cancer genetic testing.
Science and Benefits of Genetic Testing
From the methods used to stay ahead of a diagnosis to treating the disease, the breast cancer landscape has evolved in our lifetime. In 2019, we live in a world with minimally invasive techniques, targeted therapies, promising clinical trials and growing evidence of what may affect various types of breast cancer.
When it comes to genetic testing as it pertains to breast cancer, when we know someone is a gene carrier, or has a higher risk of carrying a harmful genetic mutation, we want to screen as early as possible. Approximately 10 percent of cancers are gene-related.
In the realm of breast cancer, there are a number of common mutations that have made their way to the forefront. Perhaps the most common are BRCA1 and BRCA2, genes that produce tumor-suppressant proteins. When these genes are altered or mutated, DNA damage within the body cannot be repaired sufficiently, resulting in cells having a higher likelihood themselves of becoming cancerous. According to the National Cancer Institute, approximately 12 percent of women (one in eight) will develop breast cancer in their lifetime. Those with a harmful BRCA1 or BRCA2 mutation are estimated to have an 80 percent chance of having cancer by age 80.
Additional common mutations include the genes TP53 (or p53), ATM, CDH1 and PTEN, among others.
Methods of genetic testing have evolved over the years, becoming more comprehensive and efficient in testing a number of mutations at once. In the past, these tests would identify just a few genes; they now check patients for more than 80 possible gene mutations associated with syndromes and cancer in the human body. With recent advances, it would be beneficial for patients who had gene testing prior to 2014 to be tested again with the newest assessment technology.
Recommended treatment, whether surgical or chemotherapy, may vary depending on which gene mutation is detected. All mutations are not equal across the genetic spectrum. Certain genes present a high risk for developing breast cancer and others are associated with an elevated but not a high risk; these do not equate to a necessary mastectomy. A fully up-to-date list of gene mutations and the cancers associated with them may be accessed on the NCI’s website. National Comprehensive Cancer Network Guidelines recommend prophylactic mastectomies for certain genes, and close follow up and screening with mammograms as well as MRIs for others.
In addition to the common mutations, there are many variants being discovered on a daily basis. There are databases and registries for these variants that are accessible to the public. In addition to our practice’s efforts to log and track these variants, patients are encouraged to input their information and learn more with databases like PROMPT Registry.
There are numerous pros to genetic examinations. First and foremost, if your test comes back negative for potentially harmful mutations, you may have peace of mind and return to a regular screening regimen afterward. “I recommend 40 years old as an appropriate age to start an annual mammography routine,” said Dr. Souzan El-Eid, breast surgeon at Comprehensive Cancer Centers. “Mammogram technology has improved drastically, particularly in dense breast tissue with 3-D tomosynthesis.”
If a patient tests positive for a specific gene, we dive deeper with screening scans that apply to the specific cancers associated with that gene. From there, and if there is a positive diagnosis, it’s imperative for the patient’s family (women and men) to have testing as well, as they have a 50 percent chance of carrying that gene.
The Cost of Cancer Genetic Testing
The cost of genetic testing has decreased drastically in recent years. In 2013, patent restrictions regarding genetic testing were released and several companies began offering testing. These advances focused on testing large amounts of DNA at once, resulting in a quicker turnaround, lower cost and a less-tedious process for patients.
With enhanced genetics technology and decreasing costs for patients, there has never been a better time to be proactive. Previously, a full genetics test cost somewhere between $4,000 and $5,000. Now, most commercial insurance plans cover genetic testing, but even without insurance, cash-pay price is around $250 for a full gene panel.
Looking Ahead to the Future of Cancer Genetic Testing
In 2019, the American Society of Breast Surgeons updated its recommendations establishing a new consensus guideline on genetic testing, saying it should be available to any patient with a history of breast cancer. Genetic cancer is becoming more and more accessible and perhaps, eventually, breast cancer can be as commonly screened as diabetes and blood pressure.
Needless to say, this proactive measure of genetic testing is here to stay and should be a part of a routine health screening, in my opinion. On that note, there is no time like the present to take action.
Comprehensive Cancer Centers Can Help
Medical oncologists, radiation oncologists and breast surgeons at Comprehensive Cancer Centers provide a variety of treatment options for patients with breast cancer. The following physicians specialize in the treatment and management of breast cancer.
Comprehensive Cancer Centers also offers cancer genetic counseling services for those who might be at risk for developing breast cancer or who have a family history of breast cancer. Cancer genetic nurse practitioner, Barbara Caldwell, MSN, APRN, is 1 of only 9 healthcare professionals in Nevada to receive their training from an intensive cancer genetic risk assessment program at City of Hope. She offers a thorough consultation and can put together a comprehensive medical care plan tailored to the individual and their family.
Clinical research is also a focus for Comprehensive Cancer Centers. The practice often provides patients access to groundbreaking trials in Nevada, some which are not available anywhere else in the world. To learn more, visit our website. If you or a loved one has been diagnosed with breast cancer, or would like to inquire about cancer genetic counseling, please call 702-952-3350.
The content is this post is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of qualified health providers with questions you may have regarding medical conditions.