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Before Angelina Jolie, local women understood

Residents had mastectomies after learning of genetic mutation

The name and fame of actress Angelina Jolie can rightly be credited with focusing global attention on breast cancer and two aberrant genes that place women at high risk for the scourge.

But years before Jolie had a double mastectomy in 2012 – upon learning she carried a genetic mutation that greatly increased her chances of contracting breast and ovarian cancer – some La Plata County women already had taken the radical step.

Jolie has no current signs of either breast or ovarian cancer.

Jodye and Melissa Glick, mother and daughter, respectively, both had a double mastectomy when they learned they carry a mutation of BRCA genes. The mutation increases the odds of breast cancer to 87 percent and ovarian cancer to 50 percent.Laura McSparren, who has never had breast cancer, which is common in her family, has thought at length about the risks and discussed options with family members. So far neither she, nor her two sisters, have opted to have the test for the mutated gene.

The National Cancer Institute estimates that the United States this year will see 232,340 new cases of breast cancer in women and 2,240 cases in men. The number of deaths is estimated at 39,620 (women) and 410 (men).According to estimates, 12 percent of women in the general population will contract breast cancer sometime, compared with 60 percent for women who have a mutation in a BRCA gene, the institute said.The BRCA1 and BRCA2 genes, discovered in 1994 and 1995, are tumor suppressors, but when they go haywire, they make the odds of contracting breast or ovarian cancer beyond what many women are comfortable with.

BRCA mutation discovered

Jodye Glick, about to be treated for breast cancer in 2006, reacted quickly when doctors told her that she harbored a BRCA2 gene inherited from her father.

“I had opted for a simple lumpectomy, but at that point I knew I had do something more,” Glick said. “I had a double mastectomy and an oophorectomy (removal of the ovaries) and then chemo.”

Glick has been cancer-free since 2007.

Melissa Glick was blown away by the news of her mother’s crisis.

“But I had time to prepare mentally for what I was going to do,” she said. “I researched options, but a mastectomy seemed too extreme.”

At age 32, she decided to watch and wait but every six months run through a battery of tests that included an MRI, mammogram, blood analysis, breast and transvaginal ultrasound and pelvic examination.

But two years of insomnia, depression, overeating, edgy nerves and hesitancy about new relationships – no cancer, however – made Glick realize she was no gambler. After attending a national conference about hereditary breast/ovarian cancer, she had a double mastectomy.

Dr. David Deaver, a general surgeon at Mercy Surgical Associates, said Thursday there’s no need to rush to judgment.

Only 5 to 10 percent of women who get breast cancer have a BRCA mutation, he said. On average, 60 percent of those with a BRCA mutation will get breast cancer and about 15 to 40 percent with a mutation will get ovarian cancer.

So unless a woman has breast cancer or a family history of the disease, there’s no reason to have a genetic test, much less cut off both breasts, he said.

But for peace of mind, Deaver said, women can consult a genetic counselor, who through questions and branching out a family tree, can give advice.

Breast cancer in family

McSparren, a financial counselor, is conversant about breast cancer.

Three years ago, her mother, at age 81, had a double mastectomy after her second bout with cancer. She’s doing well now.

Two cousins had double mastectectomies 10 and five years ago. They’ve had no recurrence.

Sister 1 had breast cancer 18 years ago, received chemo and is doing well.

Sister 2 had breast cancer three years ago and immediately had a double mastectomy. She’s doing well.

Sister 3, McSparren, and her daughter, Chelsea, 20, are in good health.

“I tend not to worry, but I’m proactive,” Laura McSparren said. “I told my doctor (Leanne Jordan, who died of breast cancer in 2010) that I’d have a double mastectomy.”

McSparren has discussed genetic testing for the BRCA genes with her sisters. So far none has done it.

Deaver said testing is expensive, around $3,000. The way to go, he said, is to have a family member who has cancer be tested. If the test is positive, the others can be tested for the specific mutations.

Melissa Glick, 39, who had her double mastectomy in 2009, has had no further trouble.

“I made the best decision,” Glick said. “If I hadn’t, I could have breast cancer, and I’ll do whatever to prevent further cancer. I plan to have a hysterectomy by age 45.”

Both Glicks now are members of FORCE, or Facing Our Risk of Cancer Empowered, a national nonprofit advocacy group for breast and ovarian cancer.

Jodye Glick answers a FORCE 800 telephone number to provide access to referrals or get answers to questions.

Chelsea McSparren, 20, said she has become more aware of breast cancer issues since she began heading an annual drive to support cancer research while in high school.

“I’m not going to run out and get genetic testing now,” McSparren said. “But I’d consider it if it (cancer) became an issue in the family again.

“My greatest worry is the stress it would cause, like when my grandmother had cancer,” McSparren said. “Cancer affects your family and friends.”

daler@durangoherald.com

When normal genes go bad inside the human body

The genes BRCA1 and BRCA2 normally help prevent wild cell growth, but when defective, they greatly increase the risk of breast or ovarian cancer.

About 12 percent of women in general will develop breast cancer, but 60 percent of women with an altered BRCA gene will develop cancer.

The greatest risk for breast or ovarian cancer from defective BRCA1 and BRCA2 genes is in families with a long history of cancer, the National Cancer Institute reports.

Women who have inherited a BRCA mutation are about five times as likely to get breast cancer as women who don’t have a mutation.

Blood samples are used to detect BRCA mutations by looking for changes in DNA.

A family history of cancer increases the risk.

Familial composition, with the exception of Ashkenazi Jews, can increase the risk of cancer, the institute says. Among the risky patterns:

Two first-degree relatives (mother, daughter, sister) diagnosed with breast cancer, one of them before age 50. Three or more first-degree or second-degree (grandmother or aunt) relatives diagnosed with cancer, regardless of age.

Breast cancer diagnosed in a male relative.

A combination of first- and second-degree relatives diagnosed with breast and ovarian cancer (one cancer type per person).



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