CANCER SURVIVOR OPTS FOR GENETIC TESTING TO HELP HERSELF AND HER FAMILY

Words by Jodie Tweed

IN THE MIDST OF HER OWN BATTLE AGAINST BREAST CANCER, TERESA SCHWEITZER THOUGHT OF HER DAUGHTER AND SISTER. They became two reasons why the West Fargo woman decided to undergo genetic testing to learn if she carried the gene that predisposed her to the disease.

If Schweitzer carried the mutated gene, her family members also were at greater risk of carrying it. And she could be at greater risk for developing other cancers.

Still, choosing genetic testing wasn’t an easy decision.

“In the very beginning, I thought I didn’t need testing because I knew I had breast cancer and it was going to be treated and removed,” Schweitzer explained. “But then I thought that whenever you have the ability to gain knowledge, why not take it so you can plan your treatment and let your family members know.”

Schweitzer had discovered a small lump in her left breast in December of 2013. She had an itchy spot that felt like a mosquito bite and she did a self-exam. “It was the strangest thing, but looking back, it was my body telling me something wasn’t quite right,” she recalled. “Someone was definitely looking out for me. I’m so glad I didn’t wait.”

A mammogram five months earlier had been normal but a biopsy at the Essentia Health Cancer Center in Fargo found Stage 2A breast cancer.

“At that point, your head is kind of spinning,” Schweitzer recalled. She met with her oncologist to discuss options for treatment and had a lumpectomy followed by chemotherapy and radiation.

Because she was diagnosed with breast cancer before age 50, Schweitzer met the criteria for genetic testing. She was referred to Jackie Roberts, a family nurse practitioner who specializes in oncology and provides genetic risk assessments and education at the Cancer Center.

Roberts asked Schweitzer about her personal health history and her family health history reaching back at least three generations. The detailed history helped Roberts calculate a risk percentage, or how likely Schweitzer was to be found positive and carrying the BRCA mutated gene. Roberts also outlined the risks and benefits of ge netic testing.

BRCA1 and BRCA2 are tumor suppressor genes and if they mutate then cells are more apt to develop into cancer. They account for up to 20 to 25 percent of hereditary breast cancers, Roberts explained. Of all breast cancers, only about five to 10 percent have a genetic link.

Most genetic tests come back negative, Roberts said, but the tests allow healthcare providers to find high-risk patients earlier. Patients with the mutated BRCA genes have about a 45 percent chance of getting breast cancer and other cancers, including ovarian, pancreatic and colon cancer, in their lifetimes. Some have an elevated risk up to 80 percent, she said.

“Cancer usually occurs in individuals as we age, but anybody who is diagnosed with cancer early, that’s a red flag that it could be something genetic,” Roberts explained.

Women with breast cancer may undergo BRCA1 and BRCA2 genetic testing. They may also be a candidate for the myRisk Hereditary Cancer test, a 25-gene panel that identifies risk for eight types of cancer. The tests require blood draws.

“Our patients want to prevent cancer from happening to their children,” Roberts said. “A positive mutation is a lifelong commitment to surveillance, scans or surgery. A lot of difficult decisions need to be made.”

Schweitzer was relieved to learn she tested negative for the gene mutation.

“It was a definite relief to my daughter, as well as my sister,” said Schweitzer, who is now cancerfree. “Since the BRCA mutation can be associated with uterine and other cancers, I wanted to know if I was more apt to get something else in the future.”

Cancer affects the entire family, whether you carry the gene or not. Schweitzer says she couldn’t have gone through 18 weeks of chemotherapy followed by 33 rounds of radiation without the support of her family, including her husband, Joe, and their children, Allison, 19, a pre-med student at North Dakota State University, and Jake, 17, a junior at West Fargo High School.

“Even though I’m negative now, there may be new testing in the future where I might not be so lucky. But I think the more opportunities you have to know what’s going on, the better,” Schweitzer says.