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Publications

Beat cancer before it starts

Bookmark and Share 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 genetic counselor. 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 breast cancer. 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."