Genetic tests help family fight cancer
When Mirrin Reagan was 30 years old, a possible breast cancer diagnosis was the last thing on her mind. Mammograms were recommended for most women 10 years older than Reagan.
However, Reagan’s life changed that year when she discovered a lump in her breast during a self-exam. Her doctor confirmed that she had breast cancer. Her diagnosis was the latest in a long family history of cancer.
“First, my paternal grandmother was diagnosed with breast cancer at the age of 32 and again at 52,” Reagan said. “Then, my Aunt was diagnosed with breast cancer at age 42, followed by my father’s diagnosis for prostate cancer at age 52, which returned with a vengeance.”
Reagan’s father also had been confirmed as a carrier of a mutation to a gene, BRCA2, which increased his risk of cancer. Reagan learned his status three months before she was diagnosed with breast cancer. Two days after her diagnosis, she learned that she carried the same mutation.
“I inherited my BRCA2 gene mutation from my father,” said Reagan. “At age 68, he died of prostate cancer in March.”
According to the American Cancer Society, about 5 to 10 percent of breast cancers are linked to genetic risk factors, such as BRCA1 and BRCA2 mutations. But medical experts still advise families to know whether they have these risk factors, which can greatly increase a person’s risk of cancer. Knowledge of genetic risk can help patients be proactive about screening and make informed decisions about medical treatment, whether before or after a diagnosis of cancer.
According to the National Cancer Institute, a woman’s risk of developing breast or ovarian cancer is greatly increased if she inherits a harmful mutation in the BRCA1 or BRCA2 gene. Additionally both men and women who have harmful BRCA1 or BRCA2 mutations may be at increased risk of additional types of cancer.
As a nurse practitioner, Reagan knew about the medical research on gene mutations and how they affect an entire family’s cancer risk. With all the medical clues on her father’s side of the family, Reagan began researching the science of genetic testing and how it affected her family’s treatment options.
That research became very important when Reagan’s cousin, Stacy, discovered that she, too, carried the BRCA2 mutation.
“For my cousin Stacy, knowledge of her positive BRCA gene mutation status was before any cancer had been diagnosed,” said Reagan. “She was able to initiate breast surveillance with MRIs and mammograms every six months. When Stacy was 38, an abnormal cluster of cells was found in one of her breasts.”
After considering her family medical history and gene mutation, Stacy decided to have a bilateral mastectomy and avoid chemotherapy and radiation.
“Stacy went through this journey on her own terms,” said Reagan. “Knowledge of her gene status and her ability to receive close surveillance saved [her life] and a lot of money. It is far less expensive to have one simple test, have prophylactic surgery versus the cost of cancer treatment.”
Medical experts stress that a prophylactic mastectomy is not an automatic cancer cure and may not be the best choice for every woman at risk of breast cancer. Otis Brawley, M.D., chief medical officer of the American Cancer Society, wrote in May that when a woman is facing a combination of risk factors, removing the breasts can be a sound decision.
“Women with BRCA mutations associated with a high risk of breast cancer, confirmed by testing, and with a strong family history of breast cancer, a previous breast cancer, and who show signs of certain pre-cancerous conditions are among those who could benefit from the surgery,” Brawley wrote.
Within the Reagan family, there are four children waiting to find out their gene mutation carrier status. Genetic testing is rather good news to Reagan. She has one biological daughter, Avery, and one adopted son, Sawyer.
“When the time is right, we will go through the testing and talk with [Avery] and her cousins about the implications of the [gene mutation] test,” said Reagan. “We have the medical tools that will enable them to know their status rather than [wait] to react to bad news that there is more cancer.”
On April 1, 2014, Reagan will reach her fifth year as a breast cancer survivor. Her cancer is in remission. Her personal mission is to educate family members and the community on the importance of early gene mutation testing as a memorial to her father and others who have battled cancer. Reagan’s family provides great strength to fight like a girl for others in the battle.
“I want people to know that if you have the [cancer] gene, living with that knowledge is not a death sentence,” said Reagan. “I’ve gained so much after having cancer and knowing my paternal family history.”