By July it was time to meet with the Oncologist and Genetic Counselor. Should I be tested for BRCA1/BRCA2? Prior to my visit I checked my risk as recommended using the Gail Model. This is the Breast Cancer Risk Assessment Tool that is based on a statistical model named after its inventor, Dr. Mitchell Gail . It uses a woman’s own personal history as well as family history and reproductive history to estimate risk of developing breast cancer. It gives an estimate of your risk of developing cancer over the next 5 years VS average and your risk over lifetime VS average.
The genetic counselor was first. She took a full family history. She also explained that although research has come a long way, a positive or negative test for the BRCA gene did not guarantee or eliminate risk. Another issue was the fact that my insurance would not pay for the test which has a price tag of over $3000. We discussed that if I tested negative I still had a 50% risk factor..extreme red flag. If I tested positive my risk would only increase. It was agreed that the genetic test was not really needed…I was high risk!
I was presented with three options:
- Increased screening. This option would not decrease my risk but would hopefully catch any changes quickly. This would consist of a six month rotation of Mamagram and Breast MRI.
- Tamoxifen. This would be a 5 year course and could reduce my risk as much as 50%. The reduction would put me around 25% risk and still high. The side effects include but are not limited to hot flashes, weight gain nausea and blood clots.
- Voluntary prophylactic mastectomy. The most aggressive of the option would cut my risk by up to 95%. Nothing can eliminate risk! A full reconstruction could be performed.
I was sent for an MRI while I thought about my options. I weighed many factors as I made my decision and sitting for this test was one of them. The office was busy so I had to wait for over an hour just to get back to the actual MRI room. Then I had to change into a hospital gown and sit for at least another 30 minutes. The test itself took 45 minutes. Somewhere during the MRI they insert a contrast through an IV. I had a reaction to it so my arm swelled up like Popeye and hurt! That took a few days to go down. The thought of doing this every six months, just to hopefully find cancer quickly? To be honest may have brought a tear to my eye as I tried to drive home with my huge arm. thankfully the results from this scan we normal.
The decision for me was clear!