Knowing My Family’s Health History Saved My Life
By: Erika Stallings
For as long as I can remember breast cancer has been a part of my life. During my childhood, my mom was diagnosed with breast cancer for the first time when she was only twenty-eight years old. After a lumpectomy and chemotherapy and radiation treatment, her cancer went into remission. However, fourteen years later, she received a second diagnosis of breast cancer. This time, her cancer was triple-negative, a more aggressive type of breast cancer that it less responsive to traditional treatment.
It is unusual for a person to have breast cancer before age 50; two diagnoses before that age is even more abnormal. An appointment with a genetic counselor helped us to figure out what was going on: after taking our family history of cancer, my mom underwent genetic testing and learned that she carried a BRCA2 mutation, a hereditary cancer mutation that elevates an individual’s lifetime risk of developing breast cancer up to sixty-nine percent.
A few months after my twenty-ninth birthday I decided to undergo genetic testing to determine whether I had inherited my mom’s mutation (an individual with a BRCA mutation has a fifty percent chance of passing it on to his or her children). The test results came back a month later: I also carried a BRCA2 mutation. I consulted with a number of oncologists about next steps. Individuals with BRCA mutations can undergo enhanced surveillance (mammograms and MRIs every six months) or opt for a preventative double mastectomy. Every doctor I met with advised that I should have a mastectomy as soon as possible given my family history.
Initially, it was not an easy decision. When I had imagined what my life would look like as I approached 30, I had pictured work promotions, not undergoing life-changing surgery. I was particularly worried about undergoing breast reconstruction and whether the results would feel and look natural. A mastectomy also meant that I would miss out on the chance to breastfeed if I ever had children. But over time I began to look at my situation as a blessing. I remembered what it was like for my mother when she had learned about her cancer. The first time she was caught off-guard because her doctors told her that there was no way that a twenty-eight-year-old could have breast cancer. The second time, she was blindsided by the news because she had been in remission for fourteen years. If she had known that she carried a BRCA mutation before her first diagnosis she may have been able to avoid getting cancer at all. I had the opportunity to avoid what she went through and at least I would be able to make decisions about my health and my body on my own schedule.
My mastectomy took place in December 2014. I chose to have a nipple sparing mastectomy which preserves the nipple and gives a more natural result. As a result of the surgery, my risk of breast cancer dropped from sixty-nine percent to less than five percent.
BRCA mutations are also associated with an elevated risk for ovarian cancer, pancreatic cancer and melanomas. I currently undergo enhanced surveillance to manage these risks, but I take comfort in knowing that even if I developed cancer, it would be caught at an early stage when it’s more easily treated.
My experience also led me to become an advocate for raising awareness of BRCA mutations in the black community. Black women are currently 40% more likely to die from breast cancer than our white counterparts. If you have a family member who has been diagnosed with breast and ovarian cancer or multiple close relatives with breast cancer before the age of 50, you should talk to your doctor about genetic counseling and testing. If you’re looking for a genetic counselor in your area, the National Society of Genetic Counselors has a searchable database online. Even if you test negative for a BRCA mutation, if you have a family history of breast cancer, you may need to start mammograms prior to age forty. Over the past four years I’ve learned that nothing is more powerful than knowledge.
Erika Stallings is an attorney and BRCA 2 mutation carrier based in New York City. After learning that she carried a BRCA 2 mutation in July 2014 she underwent a prophylactic mastectomy later that year. She works to educate other black women about hereditary cancer and genetic counseling and currently serves as the founding co-chair for the Basser Center for BRCA Young Leadership Council which raises money for BRCA-related research. Her writing has been published in O Magazine, NPR, Jezebel, The Cut, HelloGiggles and She Knows.