Options for High Risk Young Women
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When you’re young and at high-risk for breast and ovarian cancer, the Bright Pink way is, naturally, to look at the bright side. There are so many options out there for us now that the future has never looked better!
So let’s look at some of our options and take the first step in figuring out what’s right for us.
Your course of action includes a lot of important decisions that should be made on an individual basis, alongside a team of medical professionals – breast cancer surgeons, internal medicine physicians, genetic counselors, psychologists, gynecologists and oncologists. You should consider every option and weigh the pros and cons along with these experts who have an understanding of your unique situation.
Increased Diagnostic Testing
Chemoprevention
Preventative Surgery
Specialized Support
Increased Diagnostic Testing
As part of their plan, a lot of high-risk young women opt to undergo more frequent screening tests, including:
Mammograms
A mammogram is simply an x-ray of our soft breast tissue, and it’s the most common test used for early detection of breast cancer.
Ultrasounds and MRIs
As young women, our breast tissue more dense, making it harder to detect small breast cancers on mammograms. Sometimes ultrasounds and MRIs are used to supplement mammograms, which studies have shown to be effective.
Trans-vaginal ultrasounds can be used to look at your ovaries and help identify ovarian cancer earlier in some cases.
CA-125 Blood Tests
This blood test can be a good diagnostic tool for ovarian cancer in some, but not all, cases.
Chemoprevention
Sometimes, women who are at high risk for breast and ovarian cancer based on a genetic mutation undergo the same chemoprevention therapy that’s also used to prevent reoccurrence.
Tamoxifen is one drug that can be used to reduce the risk of breast and ovarian cancer. One study has shown that tamoxifen decreased the occurrence of breast cancer by 62% in women with a BRCA2 gene mutation. Unfortunately, there was no reduction in those women with a BRCA1 gene mutation.1
These type of treatments include some serious side effects, including possible damage to your ovaries and loss of fertility, so it’s definitely important to have an in-depth talk with your doctor. (For a bit more information about fertility, click here).
Preventative Surgery
Occasionally, young women who are at a particularly high risk for developing breast and ovarian cancer decide, together with their medical team, to undergo surgery as a preventative measure.
While it’s impossible for these surgeries to provide 100% protection from cancer – because it’s impossible to ensure removal of every single breast and ovarian cell – these surgeries significantly reduce the chances of developing breast and ovarian cancer.
Prophylactic Mastectomy
Before breast cancer is detected, some women who are at very high-risk have their breast tissue surgically removed in a procedure called a prophylactic (or risk-reducing) mastectomy.
While studies show you can reduce your risk of developing breast cancer by 95%2 and breast reconstruction can closely (but not completely) replicate a normal breast shape, you do have to sacrifice normal sensation and the ability to breastfeed.
Breast Reconstruction
While prophylactic mastectomies change the natural shape of breasts, there are many great options when it comes to breast reconstruction.
It’s important to understand that breast reconstruction is a major procedure that includes a series of surgeries. Together with your doctor, you may decide to have saline implants or silicone. Your doctor may also be able to borrow skin, fat and muscle from other parts of your body to avoid using synthetic materials.
For more information about breast reconstruction, download the Cancer Support Community’s Frankly Speaking About Breast Cancer: Spotlight on Breast Reconstruction, a comprehensive guide written in partnership with Bright Pink, Young Survival Coalition, FORCE and Living Beyond Breast Cancer.
Prophylactic Oophorectomy
Having healthy ovaries removed to reduce the risk of developing ovarian cancer is known as a prophylactic oophorectomy.
Because the risk of ovarian cancer extends to fallopian tubes, these are sometimes removed as well, and that’s called a bilateral salpingo-oophorectomy.
When you decide to remove your ovaries before you naturally hit menopause, you end up experiencing ‘the change’ after the operation. That’s a pretty major side effect and makes this preventative option a highly personal decision. If you’re thinking about a prophylactic oophorectomy, talk to your doctor and genetic counselor about your unique situation and personal risk factors so you can weigh the pros and cons together.
Specialized Support
As women at high risk for breast and ovarian cancer, we face unique challenges everyday, which is why having unique resources is so important.
Learn about the fertility options you have after chemotherapy or a prophylactic oophorectomy at Figuring Out Fertility, and talk to women like you through PinkPal Peer Support, Face-to-Face Experiential Outreach Groups and the Supportive Peer Forum.
1 http://www.ncbi.nlm.nih.gov/pubmed/11710890
2 http://www.facingourrisk.org/risk_management/mastectomy.html
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