Details for BCA COVER PAGE 5

The BRCA Gene

ctress Angelina Jolie made headlines in 2013 when she
announced she had a double mastectomy despite not
having breast cancer.
Instead, she found out she had a genetic
mutation in the BRCA gene, which significantly increased her risk of breast cancer.
Her decision jump-started a conversation about whether women should undergo elective surgery to lessen their risk of
breast cancer before any diagnosis or the
different factors to take into consideration when determining treatments.



According to the Mayo Clinic, the
BRCA gene mutation is responsible for 5
to 10 percent of breast cancer cases and
about 15 percent of ovarian cancer cases.
A blood test can find the mutation in the
BRCA1 or BRCA2 genes. You may consider this form of testing if you have a
personal history of breast cancer diagnosed at a young age or affecting both
breasts; a personal history of ovarian
cancer; a family history of breast, ovarian
or pancreatic cancer; or a relative with a
known BRCA gene mutation. People
who have a close male relative with
breast cancer are at greater risk as well.
Talk to your doctor about your family
history with all types of cancer to get a
better understanding of your risk.


If you get a positive result, this does not
mean you will develop breast cancer. If
you know you’re at greater risk, consider
more frequent clinical screenings; taking
oral contraceptives, which have been
shown to reduce the risk of ovarian cancer; chemoprevention, which is hormonal
medication that reduces the risk of breast
cancer; or Jolie’s choice to have preventive
surgery. This reduces the chance of breast
cancer by about 90 percent, according to
research. It’s not clear how much it reduces the risk of ovarian cancer.


Women who have been diagnosed with
breast cancer may also benefit from getting
the test. The national Cancer Institute discussed a study related to the BRCA mutation, in which women 40 years old and
younger who had been diagnosed with
breast cancer were tested for the mutation.
of the hundreds of women tested, about a
third told researchers it influenced their
cancer treatment — 86 percent of those
with the mutation had both breasts
removed even though both were not
affected by the cancer, while 53 percent
also had their ovaries and fallopian tubes

What to expect before and after a mastectomy


astectomy is a
treatment for women
diagnosed with breast cancer
or those who are genetically
predisposed to cancer.

The removal of one or both breasts, mastectomy surgery may involve removing just the
breast tissue or, in some cases, the lymph
nodes as well.
Data from the Agency for Healthcare Research and Quality says their analysis points
to a 36 percent increase of both single and
double mastectomies between the period of
2005 and 2013, the most recent year for data.
Women on the precipice of mastectomy surgery
will naturally have many questions concerning
the procedure and projected recovery. The process of recovering is different for everyone, and
not all mastectomies are the same. The following is a general idea of what patients can expect
before and after mastectomy surgery.

Before Surgery

A mastectomy is performed under general
anesthesia, advises the nonprofit group Susan
G. Komen. Therefore, patients should expect
to undergo routine physical exams and may
require a surgical pre-clearance from a doctor and the surgical hospital or center. Blood
tests and an EKG may be ordered as well.
Prior to surgery, patients can begin making plans for childcare, meal preparation,
shopping, work requirements, and more. As
mastectomy is an invasive procedure, patients

may experience pain and
lined by their doctors. Rest
fatigue after surgery. Havis most important during
ing various plans in play
this time, so do not overdo
well before the surgery date
exercise or other activities,
can relieve some stress and
although some movements
help patients focus on their
to relieve shoulder stiffness
may be advised.
Purchase comfortable clothPain, numbness, itching, and
ing that will be loose around
myriad other symptoms may
the arms and chest. Zip-up
occur. Take pain medications
only as needed and directed.
tops or those with front butWeakness is expected in the
tons afford easy access. Some
arms and shoulders. Ask for
women also opt to get fitted Learn about what is involved
help lifting, moving or pickfor post-op garments, includ- after a mastectomy surgery and
ing up items.
ing a lymphedema sleeve.
how to prepare beforehand.
Emotional side effects can be
Lymphedema is a swelling of
just as profound as physical
the area, and it is a common
ones. Fear of the cancer, body image issues
side effect. It is helpful to be prepared before
and a sense of loss can occur. Having a strong
such items are needed.
support team can help, as can speaking with a
professional counselor.
After Surgery
can take several weeks to start feeling
Mastectomy surgeries typically last between
like oneself again after mastectomy surgery.
two and three hours. Some may last longer if
reconstruction is performed at the same time. Women should not hold themselves up to
Patients will be admitted to a hospital stay for anyone else’s standards and be patient and
hopeful because this challenging time is tema day or two and moved to a recovery room,
Learn more at
and will need to be driven home upon discharge.
Expect to be bandaged and possibly have a
surgical drain at the wound site. The nonprofit resource says the drain
usually remains in place one to two weeks
after surgery. Fluid will have to be emptied
from the detachable drain bulb a few times
per day. Sutures that are dissolvable will not
require removal.
Patients should follow the recovery plans out-

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