by Chrissie Seals, WHNP, Salud Spa
There are exciting new options in the treatment and prevention of breast and ovarian cancer.
Years ago, patients with a family history of breast cancer would ask about MRI for early diagnosis. The medical community has had the option to order MRI for high-risk patients for many years and the knowledge that it may be beneficial. These procedures were often not covered by the patient’s insurance and completed at the expense of the patient.
Only in the last several years have we had clinical evidence and guidelines recommending different protocols for patients at higher risk for breast cancer and ovarian cancer. With new guidelines comes better insurance coverage for these patients, potentially saving lives through prevention.
How does a woman know if she qualifies for advanced surveillance?
Family history provides the information needed to develop a testing protocol. If a woman has a single family member diagnosed with breast cancer younger than 45 or two family members on the same side of the family (maternal or paternal), prevention strategies should be considered.
Additionally, a single family member with ovarian cancer at any age would qualify a patient for advanced intervention. Genetic testing, yearly MRI, yearly mammogram, frequent clinical breast exam, ultrasounds or prophylactic removal of the breast or ovarian tissue may be indicated.
Many of the options used in the strategies to prevent or diagnose breast cancer and ovarian cancer are preventative, and this dictates insurance coverage. Knowledge is powerful. Women now have the option to take medication to minimize their cancer risk, time pregnancies to coincide with best treatment or even a measure as simple as taking birth control pills can minimize the risk of ovarian cancer.
Many women also will be advised to avoid certain hormones that may increase risk.
Genetic testing for a woman with a strong family history of breast cancer may also detect information related to other risks. For example, a woman presents with two young family members diagnosed with breast cancer. Genetic testing for BRCA was negative but incidentally picked up a gene that is known to have an increased risk for colon cancer as well as breast cancer.
Testing and treatment can be customized for this patient, tailored around a risk for colon cancer that was unknown as it had not presented in her family; potentially lifesaving information.