HIGH RISK DAUGHTERS CONONDRUM
My daughter got BC at age 25, BRCA negative(at least at the time), unfortunately she is MBC now at age 31. We are all trying to move about day to day as normal as possible, BUT with so much always going on, it's quite difficult to be perfectly honest.
Doc Rad recommended my other 2 daughters get a screening mamo at age 25,and that's what we did. One daughter at that screening showed fine linear cluster microcalcifications, onto sono, MRI and then biopsy which was benign. Since then she is being checked every 6 months. From your knowledge, should we do Mamo/Sono - Mamo/MRI every 6 months, or Mamo once a yr, and the other two interchangeable. We have an appointment next wk on the 6 month mark and i wanna know if i should request a Mamo also, she is now due for sono only. Insurance should not be a problem.
My other daughter the 3rd one, just 25 showed something suspicious and after MRI and biopsy it showed sclerosing adenosis benign. She is being watched once a yr. Is this enough?
Needless to say, i am very apprehensive we should not miss something.
What is the best recommendation in this situation, with their siblings history and their own. Doc kinda said at this point it's a fluke. What say you??
Thank you in advance
P.S. - does anyone know about the validity of having them also checked for BRCA gene? Oncologists are not so sure about it. I wish there could be a straightforward thought on it.
Comments
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I'm so sorry about your DD's diagnosis. My family history of BC is scary too. The earliest onset was my mother at 27. My onc suggests that my DD start screening with annual MRI at 25. I don't have much faith in other types of screening due to the breast density of young women. I had the Brca and Bart tests a few years ago (neg) and am currently waiting for results from Color Genomics who have a 19 gene self pay breast and ovarian cancer test for $249. Even if the result are neg my DD will still need to do high risk screening. I am hopeful the liquid biopsy is perfected in the next few years making the high risk screening less onerous.
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I think the mammogram that your daughters got is called baseline and it is not recommended to get regular mammos until they are at least 35. They can still have occasional diagnostic mammos but radiation to the breast at their age should be avoided. Sonogams/ultrasounds are fine and they should get a breast exam and utrasound every 6 months. There was a study that showed that clinical breast exam is just as effective as mammo as far as OS Twenty five year follow-up for breast cancer incidence and mortality of the Canadian National Breast Screening Study: randomised screening trial . Mammo may not show much anyways since younger women may have dense breast tissue.
Weather they should get MRIs depends on their risk %. What are their risks compared to general population? Was your daughter with MBC only checked for BRCA or other genes too? There may be newer tests like PTEN, CHEK2 (there's a bunch more depending on family health history). The cost of BRCA testing has come down and you can order the test yourself too.
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Hi momallthetime,
As farmerlucy brought up, there are other gene abnormalities that may be tested for. Check out the main Breastcancer.org site's page on Other Abnormal Gene Testing for more information!
We hope this helps!
--The Mods
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farmerlucy - thanks for your support. my daughter also had prophylactic oophorectomy, as soon as she was MBC, and also bcs Onco said that it would be easier to get different tx. She ended up having a new biopsy recently bcs the monster was eating her up, and it showed that it changed from Her2- to Her2+. So different tx.
She also had Foundation One done, and really there is maybe one clinical trial that would be good for her. That's it. She is at best stable now, not much regression at all.
My other 2 daughters, are very close to her so it's really hard and they experiencing everything upclose. I go with them to the Radiologist, and sometimes i'd like to ask her something, i try not to ask in front of them bcs i don't wanna freak them out more.
Radiologist is very competent, but i never know what it is going thru their minds. She is the one that dx my older daughter at the time, and started the ball running immediately. So she knows the history, the family, i believe she has their best interest in mind, BUT i am still petrified what should i tell you!
And being that they found with the 2 other girls stuff, i am on edge. I try no to show them, we are all very good actresses.
I do wish you best of luck. You should know the first time around, her gyno was checking her 3 months postpartum, and when she showed him the olive size lump on her breast, he refused to give her a Mamo, TOO YOUNG!!!!! Right??? Ignoramus!!!!!!! We paid out of pocket and the right is history. When it metastesized to the bones, even her dear surgeon and onco, did not wanna accept it, and said maybe she just hurt herself, their minds were not going there.I had her go to an orthopedic and again the rest is history. Do you guys understand, why i feel i have such a responsibility? I feel i have to be on my tippy toes all the time.
inks - I have to ask re: redoing it, i would lie if i wouldn't tell you that i am cowardly trying to avoid these testings. It's simple, if it's a fluke that each of the girls has some suspicious stuff at this young age, it's one thing, but if it's in the genes, then it gets even more scary!! I am the type that likes to deal with the lemons life throws at us, but it's still a very hard step. (you know ignorance is bliss). I know i gotta do what i gotta do. I will spk to Rad Doc next wk at the appointment, thank you so much.
Mods thanks for the advice.
This is a wonderful site, i got a lot of help here, and i try to go on the Mets thread.
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Can you get a referral to a genetic counselor? They are trained to analyze these complex family situations and help your other daughters understand their options. The one with a cancer diagnosis would probably be the best candidate for a more broadly based panel. Then, if a mutation is found, the sisters (and perhaps yourself) can be tested for that specific defect.
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vlnrph so my daughter that has Mets she had BRCA testing it was negative, then recently i asked an Oncologist in a major Cancer Center, and he was not sure how I should go about my other daughters. So...I am not sure where we are at with this question.
To update everyone, my other daughter and myself went to the Radiologist Doc today, no mamo, sono only - and thankfully went great, we'll return in 6 months, she will then have a Mamo/Mri. We are thrilled, it was very nerve wrecking.
We move forward! Thank you everyone for your support.
I pray every day, that I am making the right choices, because they depend on me a lot for these decisions. They are very independent young ladies, but bcs of family experience, and my time devoted to do homework i am more able to get the info of what, when and where the best way to, how shall i say, protect them from this monster.
So for now, it's Mamo every other 6 months.
Thank you very much
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I wonder if there is any value to prevennia to help prevent bc? Here is a thread on it https://community.breastcancer.org/forum/79/topic/806915?page=1#post_4421596
If it is related to estrogen levels then I would assume it would only be helpful for ER+ bc. I thought you might want to look into it. (I may do my own research on it for my daughter).
Best wishes.
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hi
i am brca 2 positive and the standard for surveillance.is mri once a year and momo/sono once a year. This meeans some survalleiance every 6 months.
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Not surprising that an oncologist, when asked about family BRCA testing, would not know what to suggest. They really need to refer people to genetic counsellors. I cannot emphasize this enough.
Meanwhile, congratulations on getting through the appointments and having a short term plan. Does your clinic do 3D mammograms? I am hoping to utilize tomosynthesis technology next time because it may be better at detecting abnormalities in dense tissue. Then perhaps I might push the MRI out to every other year.
The Prevennia product is certainly expensive enough, given the chemical formula. I saw no studies referenced on their website, just a ton of anecdotal testimonials. Since it has been on the market for a while, I think that if it had truly exceptional clinical value, all our doctors and dietitians would be promoting it...
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3-16-2011 yep that's what we do now, interchangeable. What can i tell you, i still fret all year. We were so anxious this time around. We are very lucky, i found a private Radiologist Doc, she is very capable and caring, she was there when my daughter was first diagnosed, i use her, so she knows all family history, and it's a very nice feminine environment, being that they are all so young we all appreciate this, and the staff is great. It does not take away the fear, but it's better than rushy or rude staff. I tried going to a Hospital run mamography and they were so detached and cold, it was quite unpleasant. I have to pay out of pocket here, so that's my luxury. For real. Best of luck on your scans.
vlnrph - i cannot understand how a super top Clinical Oncologist in a top Cancer Center in NYC should not be able to give me a definite answer in the sense that if my oldest daughter showed she is BRCA negative what's the steps for the rest of the family. I tell you the truth i am usually the type to go check what the noise at the door is, but I am not to keen about testing the rest of us. Awhile ago I watched a documentary on PBS about BRCA testing, and how some sisters in a family did not wanna be checked and I thought how weird, they could be doing something about it and they are not. And now I am doing the same thing. The other 2 sisters are 25/28 single, so to be honest I am not looking forward to find out some horrific news, we might do it, just wanna push it of some. I have the original geneticist that took care of my oldest daughter, i might give her call, soon.
I will ask the doc about Prevenia, thou i am skeptical of this things.
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I am skeptical of Prevennia also, I think vinrph is correct - if it was so great we would be hearing about it all over the place.
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