Cancer Awareness
Advances in Breast Cancer Care
WHEN ANGELINA JOLIE CHOSE to have a prophylactic double mastectomy in 2013, despite not being diagnosed with breast cancer, it left many wondering why. Jolie had learned she had a genetic mutation called BRCA, which put her at a heightened risk for breast cancer. Many more women since that time have opted to have the same procedure in order to ensure that breast cancer would not be a part of their future, and have chosen to have all breast tissue removed. For patient Sarah Olivier, it would be a different genetic syndrome which put her at risk for a variety of cancers, including breast cancer. Because her aunt had breast cancer at the age of 43, Sarah began getting mammograms at the age of 35. With dense breast tissue, there were always questions as to whether the mammogram could be a definitive diagnosis, so radiologists would recommend an ultrasound and often an MRI, as well. Suspicious lesions would often involve biopsies in which small pieces of tissue were removed for analysis. Over the next 12 years, Olivier would have five biopsies because of suspicious radiology. Every time she waited for the results, it was agonizing. “At that point, I decided to have genetic testing, which was done in December 2019,” remembers Olivier. “The genetic testing came back positive for Lynch syndrome, a rare condition that put me at a much greater risk for many cancers, including breast. I went to see my ob/gyn doctor, who referred me to breast surgeon Dr. John Colfry, who told me he had rarely seen a patient who had already had five biopsies, and that I was quite literally a walking time
photo: MILESTONE PHOTOGRAPHY MELANIE LANGTEAU
by Leslie Cardé
bomb.” In this particular patient’s case, not only was there the genetic component, but her family history created an exponential problem. Not only was her aunt an issue, but Olivier’s own mother had been diagnosed years earlier with colon cancer---another Lynch syndrome cancer. “Genetic testing has become much more sophisticated of late,” says Colfry. “Twenty years ago we tested for the BRCA 1 and 2 genes. These days there are nearly 40 gene mutations that we can find... among them Lynch syndrome. It’s not one of the common ones, and breast cancer is certainly on the spectrum, but not as strong as colon cancer. However, her strong family history along with that gene mutation caught my attention.” Mastectomies, once upon a time, were disfiguring. >>
Drs. John Colfry and Ravi Tandon.
O c t obe r - N ov e m be r 2 0 21
31
