Thursday, May 16, 2013

Breast Cancer Risk-BRCA and Angelina Jolie

Thanks to Angelina Jolie, the awareness about Breast Cancer has hit the roof. Any kind of publicity is good! Those interested in reading her op-ed and comments can click here, here, here.

You can read some interesting views and points worth considering here and here.

If you are a person with BRCA 1 or 2 mutation what should you do?

What are the questions you should be asking?

Here the list goes.....

1. What is the sensitivity and specificity of BRCA testing? To put it more crudely how many times does the testing give a positive report when the person does not have BRCA and how many times does it miss the positive ones!
Will not complicate it with introduction of positive predictive value.

2. What do you mean by 60-80% risk of developing breast cancer when i am BRCA positive?

Normal woman have 2-10% risk. That is out of 100 woman 2 to 10 women can develop cancer. But at what age?

Ok. In BRCA positive ladies, the chance of developing cancer is more. That is out of 100 ladies with BRCA positivity 56 to 84 of them will develop breast cancer. They are also at increased risk for ovarian cancer.

3.Important question to ask, at what age does my risk peak? If at all i have to get mastectomy done, what is the optimum age?

In one study the mean age of people who underwent surgery and showed to have benefit had median age of 40 years.

4. What other modalities are there? Tamoxifen, oophorectomy? that is removal of ovary. How good are these options?

5. What are the risks of various treatments?

When you visit your doctor or genetic counselor, please ask these and any other question which you want to.

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