Beat cancer before it starts
When celebrity Christina Applegate learned she had
breast cancer, she made a life-changing decision: She
underwent a prophylactic double mastectomy, the
surgical removal of both breasts.
It was a dramatic step but, to her, a reasonable one.
Both she and her mother, also a breast cancer survivor,
carry a mutation in one of their genes. A mutation or
alteration in these genes increases the risk for both
breast and ovarian cancer.
"Genetics can influence our risk for certain diseases.
They can also affect the severity of the disease," explains
Janice O'Connell, MS, CGC, Fox Chase Virtua
Health Cancer (FCVH) Genetics Program certified
Five to eight percent of all breast cancer cases are
considered hereditary but only a portion of those
patients has a genetic alteration that increases their risk
for breast and ovarian cancer. These individuals may
develop more aggressive diseases. And, they have a
higher risk of also developing a second breast cancer.
Laura Dolan's family falls into this category: Her
mother, grandmother and aunt all have had breast
cancer. Worried she might harbor a genetic breast
cancer mutation, 45-year-old Dolan went to a trusted
source for genetic counseling and testing: the FCVH
Cancer Genetics Program. There, a team that included
a genetic counselor, a genetics nurse, medical oncologist
and breast surgeon advised her.
Reducing cancer risk
Trina Poretta, DO
, Virtua medical oncologist, says
genetic testing is only part of what the program offers.
"We look at a patient's personal medical history and
the family history to determine if genetic testing is
needed. We educate people about the benefits and the
risks of testing. For all patients, we discuss cancer
risk prevention strategies - to prevent cancer from
occurring or diagnosing it at its earliest stage."
It's a total program that includes education and
counseling, genetic testing, risk prevention and the
chance to join a genetic research registry.
Through testing, Dolan learned that she had a
genetic mutation within one of her genes and with
it, up to an 87 percent chance of developing breast
cancer in her lifetime.
"First I cried, then I got busy," says Dolan. "I was
closely monitored for breast cancer by Diane Gillum, MD
a Fox Chase Virtua Health Cancer Program breast
surgeon, with twice yearly magnetic resonance breast
imaging (MRI) and digital mammography."
High surveillance pays off
Last May, a breast MRI showed an area of concern in
Dolan's right breast, which proved to be early stage
The treatment plan she and her physicians created
was based on her overall health, age, family history and genetic profile: a double mastectomy with chemotherapy
followed by breast reconstruction. "Every case
is highly individual," explains O'Connell, "there is no
one size fits all treatment."
Dolan has since completed chemotherapy. She says,
"I'm living proof that your genes are not your destiny,
thanks to my Virtua team."