"I have the BRCA 1 gene, so I made like Angelina" - Doctors urge SA women to get breast checks

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Illustration. (Getty Images)
Illustration. (Getty Images)
  • In 2020, many women may have put off regular screening because of the Covid-19 pandemic and lockdown. As South Africa adapts to Level 1 of the lockdown restrictions, we are urged to check in on our health amid a rise in breast cancer cases worldwide.
  • This is because the rapid onset of Covid earlier this year focused people's health priorities away from more routine medical matters.
  • Here, Trishal Lazarus tells her personal story of how she looked out for her health after testing positive for the BRCA 1 gene and opted for prophylactic double mastectomy as a preventative measure against breast cancer. 

Early detection is key to surviving many cancers, and breast cancer is one of the most common cancers to be diagnosed in South African women. It also has a high survival rate if caught early. In fact, the five-year survival rate for stage 1 and 2 is - on average - above 80 percent.

We are currently observing Breast Cancer Awareness Month, and we're all (yes, men too) strongly advised to examine for lumps. However, Dr Dominique Stott, Liberty's Chief Medical Officer, explains that "breast cancer doesn't always present itself as a lump, so it’s a good idea to have a mammogram done."

She adds that "if you notice any changes to your breasts such as a lump, skin or nipple changes or discharge, whether it is painful or not, you should see your doctor immediately." 

READ MORE: “I took my nipples for granted — until I got breast cancer”

The upside is that early detection usually leads to more successful treatment. 

Research shows that 95 percent of women with stage one breast cancer are cancer-free five years later. This highlights the importance of health check-ups and vigilance no matter your age – particularly in going for regular mammograms as indicated by your doctor.

This is of even more importance if you come from a high-risk cancer family. "If members of your family have had a breast or ovarian cancer diagnosis, then your risk could be higher," Dr Stott advises. Other risk factors include obesity post-menopause, having a child later in life, or no children at all, dense breast tissue, alcohol consumption, inactivity and some forms of HRT.

"Given that the lifetime risk of breast cancer in South Africa - according to CANSA - is one in 25 women, it is essential all women are prepared for it," she says. 

A woman who heeded such advice is Trishal Lazarus, who penned her story for Women's Health. Trishal - being aware of her genetic predisposition to breast and ovarian cancer - underwent genetic testing and found that she too has the BRCA 1 gene.

This is her story:

From a young age, I have been exposed to the reality of cancer. My mom was diagnosed with breast cancer at age 31. At the same time, my grandmother was undergoing treatment in her mid-50s.

My maternal family has a history of four generations of a genetic predisposition to breast and ovarian cancer. My mom and grandmother both tested positive for the BRCA 1 gene. It was inevitable that I would have to undergo genetic testing too.

READ MORE: 5 signs of breast cancer that have nothing to do with lumps

At 24 years old, after receiving genetic counselling, providing a blood sample and waiting three weeks for results, the counsellor sat in front of my dad and myself and told me that I was positive with an 87 percent risk of getting cancer in my lifetime.

What exactly is the BRCA 1 gene?

The name “BRCA” is short for “breast cancer gene”. Everyone has BRCA 1 and BRCA 2 genes, but some people’s genes don’t have normal functionality, which then becomes gene mutation. These mutations can be passed from one generation to the next.

READ MORE: Exactly what to do if you notice a lump in your breast

I was given two preventative measures: have regular screening such as an MRI scan or mammogram every six months, or reduce the risk considerably by having a radical double mastectomy.

Personally, constant screening is more emotionally draining and extremely costly. The thought of lying in the MRI machine for two hours being injected with a dye that burns as it goes through your veins gives me the jitters.

I couldn’t stand the chance of cancer appearing at any point in my life, so I chose to have a prophylactic double mastectomy with immediate reconstruction.

But things don’t always go as planned…

day-of-surgery

This picture is me on the day of my surgery, before going in. The surgery was scheduled for two hours, but unexpectedly took five hours due to complications. Fibroids and dense tissue made surgery more difficult.

A mole and enlarged nodes were also discovered. While histology results came back negative, it confirmed that my mastectomy decision was the correct one.

I was disappointed that the implant size I wanted didn’t materialise and I had to endure two additional cuts and scars (four cuts and two drain incisions in total).

The lesson: don’t have expectations going into such a procedure – things may not go as planned.

The worst part of the process was having drains inserted on either side of my breasts to drain all the excess blood.

Every movement or turn tugged at the drain, which was excruciating.

READ MORE: 7 early warning signs Of stomach cancer every woman should know

People were right when they said that the four days in hospital was going to be the “honeymoon period”. Only when I got discharged did reality sink in.

I was unable to shower for several weeks until the drains came out and my wounds healed. The only perk was getting my hair washed for me.

To this day, I find sleeping on my back in one position hard to adjust to. Tip: get extra pillows – a pregnancy pillow is a bonus.  

The recovery

three-days-after-op

This is me three days after the operation. I was surprised by how quickly my body adapted to change: a few weeks after surgery, my nipples and scars started scabbing.

I was also surprised when I started getting an electrocuting, shocking feeling run down my arms at night. Thankfully, my surgeon was on speed dial.

Her response: think of your nerves as power lines. As soon as you interfere with them (removing the nodes under my arms) there is no longer a smooth running line, hence the shocking surge.

This pain doesn’t happen to everyone and lasts different lengths of time.

READ MORE: 9 lung cancer symptoms all women should keep on their radar

Another thing that takes time getting used to is the loss of feeling in your breasts and underarms, but at least now I won’t have to deal with the pain of underarm waxing!

Prevention is better than cure

I’ve never been happier with my decision – and I plan to have a hysterectomy at 35 to reduce my risk of ovarian cancer. I’ve sacrificed breastfeeding when I have kids, but to me it was a choice between breastfeeding or prolonging my life…

READ MORE: Every woman should know how breast cancer affects fertility

And if this mutation (BRCA gene) can pass from generation to generation, how can I prevent it from passing on to my offspring? Well, there is pre-implementation genetic testing using in vitro fertilisation (IVF) to test for the gene mutation and remove it.

There are obviously a lot of factors to consider and it is costly, but it just shows that with the advancement of technology and science, there is always a way.

This article was originally published on Women's Health 

Additional information provided by Liberty

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