Fall, Fear and BRCA

It’s hard to miss the signs of fall. The cool breeze in the air, the beautiful colors of the leaves and come October the pink ribbons. October is Breast Cancer Awareness Month.  Many writers address this very complex issue. They talk about prevention and stress the importance of early diagnosis. 

In my practice, I work with many clients who struggle with a variety of emotions.  We often talk about fear, anxiety, stress and depression. Obviously these feelings may arise for many reasons. Breast cancer is just one of them. However, unlike many other types of cancer, most people know of the options for early detection. We are often told of these options and encouraged to explore them. 

Mammograms and ultrasounds are two effective methods of detecting tumors in their early stages when they are more easily treated. They are easy and safe.  True, the exam is a little uncomfortable and personal, but compared to the option of not testing, it’s simple. So why do so many women avoid these tests? Denial. Fear. Avoidance. 

This issue becomes even more emotionally loaded when heredity plays a role.  Women with a strong family history of breast cancer are often encouraged to undergo genetic testing for the BRCA gene. While a positive test does not mean the patient will develop breast cancer, there is an increased risk. Knowledge is power…the power for early education, prevention and preparation. 

Despite all the obvious benefits, a positive test result can be difficult to accept and digest; it also opens the door for more questions including what and when to tell the children. While some advocate sharing this information with daughters, age and emotional development are important factors to consider. Breast cancer is rare in teenagers and young adults. Knowledge of a positive BRCA result can have a profound impact on a young woman and her emotional well-being.  However, many of these women have seen their mothers, aunts and grandmothers fight this disease. They are aware of their heightened risk status even without test results. Education and self-examination are the most important tools for our daughters. With the appropriate education, they can determine whether or not to test.

What is your view?