A Happy Birthday to me! Yes, today is my 26th birthday and while I know I am a baby I feel old! My husband Chad and I leave for Fort Lauderdale Thursday and I did the dreadful bathing suit shopping of Nordstroms earlier last week and literally told the young sales woman that I thought I was too old for at least HALF of the suits they sold. I think she thought I was crazy lol. (Just like Chad said when I told him I would be ready for Botox in 5 years tehe)
A Reminder on My Birthday- CA125
So for my birthday I decided it might be a good idea to get my CA125 test done. Not that I particularly felt like having blood drawn on my birthday but I happened to be near a lab that my insurance would accept and I have been carrying around the order from my gynecological oncologist for over two weeks now. A lot of the women I know, of all ages go to Georgetown for all of their medical checkups, kind of like a one stop shop. I have decided for the gynecological work-up to go to a private physician who does not do the blood work in house. Because of this I had the pleasure of heaving to explain BRCA to this woman so she could try and figure out the ICD-9/procedure codes and it just took forever. The woman was nice enough but I tried everything: high risk, ovarian cancer, breast cancer, gene mutation. I told her to call the doctor. It actually was somewhat amusing towards the end. I don’t even know what she ended up putting but I will have a fit if they don’t approve it. It just made me think that it might be a good idea to start carrying these things around with me. I was obviously in a good mood today but had I been upset for any reason this could have made me really angry.
So What is BRCA Anyways?
Just like the woman who drew my blood for the CA125, unless BRCA runs in your family, not many people know what it is exactly so I thought I’d share some very basic, elementary information in what BRCA is. BRCA1 and BRCA2 are genes that are classified as tumor suppressor genes. When someone is BRCA1 or BRCA2 positive is means that they inherited a deleterious or harmful mutuation within one of these two genes and which, for a woman, greatly increases her risk of developing breast and/or ovarian cancer and for men, greatly increases his risk of breast cancer. Both men and women who have harmful BRCA1 or BRCA2 mutations may be at increased risk of other cancers and have a 50% chance or passing the gene to their offspring (called autosomal dominant inheritance). Many people forget that the gene can be passed down from men and in my family, I inherited the gene from my mother and from her father. Just some food for thought.
Being BRCA1+, I have an 87% risk for breast cancer and a 44% lifetime risk of ovarian cancer. (Those statistics are slightly reduced for those that are BRCA2+). With the normal population have a risk around 1-3%, I hope that helps in terms of understanding the significance of the severity of a positive mutation.
This is a really good question and something I will discuss in great detail as there is not one exact answer which is extremely frustrating. It is recommended that you see a gynecological oncologist so I see mine every six months and I really like her. You are to get the CAA125 blood tests, Mammograms once a year with an MRI in between so you are being screened every six months and a pelvic ultrasound every six months. Other than that, all the surgeries are pretty much up to you.
I really like my gyncecological oncologist and I am fortunate to have found someone that I really like who is educated on BRCA. My theory is if you don’t like/trust the person you can easily fall out of the routine which is really easy to do. Right now I have opted to do surveillance until I decide exactly what options are best for me so staying on top of the checkups and things are critical. Unfortunately, I have not found my “team of doctors” just yet but I am on the lookout. I am really bad about doing all the blood tests, mammograms, MRIs and things on time. It just feels like I am ALWAYS making an appointment, waiting in a waiting room and I just don’t have the patient or the time. It is hard enough being young and working on carrier. Adding all this on top of it. I feel like I am always a month or so behind. Last 6 months I just completely forgot to get my CA125…
My decisions moving forward:
I have decided to do a preventative double mastectomy, which is the medical term for the removal of both of my breasts. My only decision now is should I do this before or after I have children? I am really struggling with this decision as I am probably only 2 years from, as Chad puts it, trying to not have a baby =)
Now is BRCA years, a women who is BRCA1+ has an 87% lifetime risk of breast cancer and risk is young but rarely in the early 30s. HOWEVER, in my family my aunt was 29 was she was diagnosed with breast cancer (pregnant might I add) and my own mother was 37 with ovarian. So in my family the women are extremely young. While I know the benefits of breast feeding are statistically significant, I really wonder if they will be relevant for me… should I even risk it?
These are all things for me to consider as I move forward through my young-oldish age of 26. =)