T.J. Samson | Destination Health | February 2020

Cancer care A breast cancer diagnosis reveals a family secret L aura Turner, 60, has lived under the shadow of breast cancer for most of her life. Her mother died of the disease when Turner was still in her 30s. Breast cancer also took the life of her maternal grandmother. That history is why Turner never missed a mammogram and why she was so alarmed to discover a lump in her breast just six months after a routine breast x-ray in 2018 found nothing at all suspicious. “I was scared to death,” she recalls. That lump did turn out to be cancerous. As a result, Turner opted to have a mastectomy, followed by chemotherapy, at T.J. Samson Com- munity Hospital. But that is just the beginning of her story as a breast cancer survi- vor. Genetic testing—advised by T.J. Samson Oncologist Yashpal Modi, MD—revealed that Turner is one of the estimated 5% to 10% of all breast cancer patients with he- reditary cancer. FAULTY GENES Abnormalities in two genes, BRCA1 and BRCA2, cause most hereditary breast cancers. Typically, BRCA genes help to prevent cancer by cre- ating proteins that keep cells from growing abnormally. Women who inherit a mutation in either gene, however, have a significantly raised risk of breast and other cancers, espe- cially ovarian cancer. Cancer in both breasts is also more common. Turner inherited a BRCA2 gene mutation. Most women with a family his- tory of breast cancer do not have an inherited gene change. But a BRCA mutation is more likely with a strong family history of breast cancer, particularly if certain other cancers—including ovarian, pancreatic and prostate cancers—are prominent in a family. Men can inherit BRCA mutations too. Turner’s older brother died of pancreatic cancer—a red flag that a faulty gene might run in her family. UNSETTLING NEWS Shortly after Turner’s mastectomy, her genetic test results came back. When Dr. Modi broke the news— and explained the choices ahead— Turner was stunned. “Before all this, I’d never even heard of a BRCA gene,” she says. “This was more painful news I didn’t want.” Ultimately, Turner decided to undergo two preventive surgeries at T.J. Samson: a mastectomy on her remaining breast and a hysterectomy in which both of her ovaries and fallopian tubes were removed.The surgeries don’t entirely eliminate her risk of developing ovarian cancer or a second breast cancer. But they reduce her risk considerably. “I’ve come out on the other side,” Turner says. “There’s such a huge weight off me. I feel I’ve beaten this gene.” Turner is one of nine siblings. She’s told each surviving one, as well as her adult son, that she’s in- herited a BRCA2 mutation—and they may have too, since the muta- tion is passed on from a parent. She knows that information can be lifesaving. And she feels her three physicians at T.J. Samson— Dr. Modi; Todd Marion, MD, who performed both mastectomies; and John Craddock, MD, who per- formed the hysterectomy—have added years to her life. “I can’t thank them enough for their expertise and their compas- sion,” Turner says. Gene t i c t e s t i ng he l ped one woman t ake cha r ge o f he r hea l th 2 DESTINATION HEALTH