What do your genes say about your breasts?

A recent article in the New England Journal of Medicine says we're getting closer to a genetic test for breast cancer risk.

Published June 26, 2008 6:40PM (EDT)

According to the BBC, we're getting closer to the day when a gene test can determine your likelihood of developing breast cancer. A recent paper in the New England Journal of Medicine says that scientists have figured out that in addition to lifestyle risk factors, several gene faults are likely associated with a higher risk of breast cancer. Eventually, they say, we might be able to screen women for these faults with a simple cheek swab.

The test results presumably would help sort women into groups based on genetic risk, with higher-risk women encouraged to get more regular screenings. "We believe genetic testing has the potential to enable doctors to identify a woman at an increased risk of breast cancer who would benefit from mammography at an early age or a woman who may benefit from regular MRI scanning as well," Dr. Paul Pharoah, of the University of Cambridge, is quoted as saying. Conversely, a woman with low genetic risk factors might be able to cut back on her number of screenings -- which could be particularly financially useful in the case of younger women, since their breast tissue has a different density from that of post-menopausal women, and thus is best evaluated by a more expensive MRI scan (as opposed to conventional X-ray mammography).

The test is still years away, but nonetheless, it's already controversial. A representative from a cancer center said that regardless of genetic testing, the center still recommends that older women be encouraged to have their breasts screened, saying that "it is a free facility that can save lives and all women should be encouraged to take it up when offered to them." And, of course, there's the question of what insurance companies would do with this information. I personally wouldn't mind knowing if I had a high genetic risk for breast cancer, but I certainly wouldn't want my insurance company to find out about it (my monthly premiums are high enough as is). But I'd also worry that if my risk were low, the company would limit the number of screenings I could have, claiming that my genes rendered the tests unnecessary. I suppose I fall into the camp of people who want to know their breast cancer risk and have their mammographies, too -- but what can I say? When it comes to minimizing my cancer risk, I guess I want it all.


By Catherine Price

Catherine Price is an award-winning journalist and author of Vitamania: How Vitamins Revolutionized the Way We Think About Food. Her written and multimedia work has appeared in publications including The Best American Science Writing, The New York Times, Popular Science, O: The Oprah Magazine, the Los Angeles Times, The San Francisco Chronicle, The Washington Post Magazine, Salon, Slate, Men’s Journal, Mother Jones, PARADE, Health Magazine, and Outside. Price lives in Philadelphia.

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