Wellness

[Mindy D]

The Hi All. I don’t think enough ladies have seen my post about new, expanded, guidelines for all breast cancer survivors. It is now advised that you visit your doctor for a risk assessment, a questionnaire, to determine whether you need testing for the genes that can cause breast cancer. This assessment is advised for all survivors no matter what their age or how long ago they had cancer. The genes associated with this are known as BRCA 1 & 2. Survivors of other cancers are now included in this expanded assessment requirement as well as relatives of cancer victims and persons whose ancestry is Ashkenazi.

“The USPSTF recommends that primary care clinicians assess women with a personal or family history of breast, ovarian, tubal, or peritoneal cancer or who have an ancestry associated with breast cancer susceptibility 1 and 2 (BRCA1/2) gene mutations with an appropriate brief familial risk assessment tool. Women with a positive result on the risk assessment tool should receive genetic counseling and, if indicated after counseling, genetic testing.”  

Quoted from “BRCA- Related Cancer: Risk Assessment, Genetic Counseling, and Genetic Testing; Release Date: August 2019

https://www.uspreventiveservicestaskforce.org/Page/Name/home

[patbz]

@Mindy D :  What does your post mean?  I have a relative who got breast cancer in her twenties (and a double mastectomy and those textured implants that they just pulled off the market).  What do these new guidelines mean for her (would be nice if govt got manufacturer to stand behind their implants and pay for removal).  My relative is very scared (she's not quite forty).

[Mindy D]

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@patbz wrote:

@Mindy D :  What does your post mean?  I have a relative who got breast cancer in her twenties (and a double mastectomy and those textured implants that they just pulled off the market).  What do these new guidelines mean for her (would be nice if govt got manufacturer to stand behind their implants and pay for removal).  My relative is very scared (she's not quite forty).

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It just means that when she sees her primary care doctor she should let him or her know about her cancer so that she can be asked a few questions. Her answers to the questions will let the doctor know if she needs a test to see if she carries one or both of the two genes that cause a type of breast cancer. The genetic breast cancer is not related to the type of breast cancer from the textured implants. Chances are that if your relative was recently diagnosed and her cancer was determined to be related to her implants or/and she is in her twenties she was already tested for this type of cancer when she was being tested before her diagnosis. In other words, breast cancer that comes from the implants is not related to genetic breast cancer. Either way, if your relative was recently treated she was probably tested for genetically caused cancer before her diagnosis. She should still mention her cancer to her primary care doctor when she goes in for her visit. 

Did your young relative have cancer related to textured implants? Was she told this by her oncologist? Just because her implants were removed at the time of her mastectomy does not mean her cancer was related to the implants. This is actually not considered a true breast cancer but is an extremely rare type of lymphoma. The lymphoma can show up in breast tissue or in other areas of the body. 

Breast cancers for young women in their twenties can be gene related breast cancer such as BRCA1 and BRCA2. Your young relative might be scared but it’s important that she become aware of the type of breast cancer she had. BRCA1 and BRCA2 genes can also cause other cancers including ovarian cancer. Some young women choose to have their ovaries removed to prevent ovarian cancer.

There are other breast cancers that are not related to the implants, or BRCA cancers.  Your relative is scared and I completely understand her fear and I have the utmost sympathy for her. It’s can be even harder for some young persons to deal with serious illness because they might not have been exposed to illness as often as older persons. 

For further information see

https://www.cancer.org/cancer/breast-cancer/risk-and-prevention/breast-cancer-risk-factors-you-canno...

 https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/types-of-breast-...

[sann]

If you have any questions discuss with your physican. Someone who is an expert.

[HerRoyaLioness]

I am a breast cancer survivor.  My insurance would not pay for it because I did not meet the criteria to need this kind of testing. It is expensive.

I would like my daughter to have it, but again, insurance is an issue. 

[Mindy D]

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@HerRoyaLioness wrote:

I am a breast cancer survivor.  My insurance would not pay for it because I did not meet the criteria to need this kind of testing. It is expensive.

I would like my daughter to have it, but again, insurance is an issue. 

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This is about an assessment questionnaire that your doctor will do with you to see if you need the genetic testing. Since there are brand new recommendations, if you meet the criteria for genetic testing, your insurance might pay now. 

[HerRoyaLioness]

@Mindy D  - I did meet with a Genetic Counselor and filled out a questionnaire.  The only thing I see that is different maybe is a personal history of bc, which I now have.  I was adding up the points, just in my head, and seem to be barely under the level for that kind of genetic testing. 

I am now on Medicare and for sure they won't pay!  Plus some insurances still won't pay even if standards of care have changed.  I encountered that time after time when working in the medical field.  The insurance would require a certain test for their members, but then wouldn't pay us for doing it - the charge would be denied!  Hoe they continue to get away with this is beyond me.

I guess it's my daughter I worry about, actually my sons too, because now they have a family history of bc. I  had no family history of bc at all.  But it seems like it is becoming almost an epidemic and younger ones are getting it.  The genetic counselor said my daughter just has a normal risk of bc, it's almost all environmental and I tend to agree with that.

But anyway, thanks for putting this out there!

[Financialgrl]

I am a breast cancer survivor - my grandmother and mother both had the disease; my grandmother died of a heart attack and my mother from the cancer. 

In 2011 I was dx and then had genetic counseling and was tested for the BRCA gene.  Not sure about today but back then only one company (Myriad) tested for it and it was pretty expensive (I want to say it was $3000).   I thought I had read that another company also does it now or that they were being approved to do it.  

[keithsmom65]

Implants are elective. No one HAS to have them to live. You pay for them, you accept the risks.

[HerRoyaLioness]

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@keithsmom65 wrote:

Implants are elective. No one HAS to have them to live. You pay for them, you accept the risks.

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@keithsmom65, if you are referring to @patbz comment, I am quite sure that the risk was not known to her at that time or she wouldn't have put those kind of implants in.  These are issues that come up later.

No one has to have them to live, but it is an option we can have, just like any other prosthetic, when we lose a body part.  This is a sensitive body part to some of us.

Especially when you are in your twenties.  Nothing wrong with wanting to look nice and have your clothes fit.  This was not to just enhance or enlarge her breasts for purely cosmetic reasons, she had breast cancer and mastectomies, a painful and devastating process, both physically and emotionally.

We trust the manufacturers of these products, unfortunately their money making seems to be a priority for them.  Not our fault. Period.

I find your comment insensitive and uneducated.  I hope you never have to make that choice, as you never know what you will do until you are actually in that situation.