Understanding breast cancer genetic testing
When should you consider undergoing genetic testing for breast cancer?
The latest Singapore Cancer Registry Annual Report (2016-2020) indicates that Breast Cancer1 is the top cancer and top cancer deaths among Singaporean women. 1 in 15 women in Singapore will develop breast cancer before the age of 75 and the chances of developing it increases with age.
Good news is, with early detection, it can increase your chances of survival. You might have heard of mammograms, ultrasound and biopsy but have you heard of genetic testing? So what exactly is breast cancer genetic testing and should you go for it?
First of all, there are two known breast cancer genes (BRCA): BRCA1 and BRCA2. When a BRCA gene is mutated, this can significantly increase the risk of developing breast cancer and ovarian cancer.
Hear from Dr Shang Yeap Heng Oon, Senior Consultant, Specialist in Medical Oncology from Icon Cancer Centre to understand about breast cancer genetic testing.
Q1. My mother had breast cancer before and is now in remission. Should I undergo genetic testing? Why didn’t the doctor recommend for me to receive genetic testing?
Most breast cancer patients and their family members do not need to receive genetic testing. This is because genetic testing only detects the genetic causes of breast cancer. Hereditary breast cancers typically account for up to 10% of all breast cancers, so genetic testing won’t be appropriate for most breast cancers.
Who should receive genetic testing for breast cancer? Generally speaking, breast cancer patients are the first to be considered. Therefore, if genetic testing is necessary, the doctor will consider your mother to first receive genetic testing. Factors that determine the need for genetic testing include the age of the person when diagnosed with breast cancer, type of breast cancer, number of family members with breast cancer and any family history of other types of cancer, such as ovarian cancer.
Once we have the above information and if we find that your mother is likely to have an inherited gene mutation for breast cancer, then she may be recommended to undergo genetic testing. She will also be advised to consult a genetic counsellor, who can provide advice on the types of genetic testing that would be appropriate and what it means to test positively for an inherited breast cancer mutation.
If your mother is found to have an inherited gene mutation for breast cancer such as BRCA1 or BRCA2, the doctor will discuss the increased risk of breast cancer and other cancers such as ovarian cancer and pancreatic cancer. The doctor may also suggest surgery to reduce the risk of cancer in the future, such as prophylactic mastectomy or salpingo-oophorectomy (removal of the ovaries).
Meanwhile, as a member of her immediate family, you will also be advised to receive genetic counselling and possibly undergo genetic testing.
Q2. If I test positively for an inherited breast cancer gene mutation, does this mean I will definitely get breast cancer?
Even if you test positively for an inherited breast cancer gene mutation, this does not mean that you will definitely get breast cancer.
However, your risk of developing some types of cancer is much higher, such as breast, ovarian and pancreatic cancers. It is recommended you should consult with a doctor and receive counselling to learn about screening for these cancers and may need to undergo surgery to reduce the risk of these cancers and help prevent their development.
The article is contributed by Dr Shang Yeap Heng Oon, Senior Consultant, Specialist in Medical Oncology from Icon Cancer Centre.
Prevention works best when you plan early
Prevention is always better than cure – go for regular mammograms to detect any abnormalities early so that survival chances are higher and recovery can be better managed. Treatment of breast cancer can be extensive and for those diagnosed with breast cancer, they may face a 3% to 15% chance2 of recurrence within 10 years.
While all Singapore Citizens and Permanent Residents are covered under MediShield Life, the public health insurance scheme, it may only cover a portion of the total cancer treatment costs, within specified claim limits.
Have peace of mind knowing that our GREAT SupremeHealth and GREAT TotalCare plans come with comprehensive outpatient cancer drug treatment benefits to defray the cost of cancer drugs and treatments not covered under MediShield Life. Terms and conditions apply.
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Footnote:
1 Singapore Cancer Registry Annual Report 2020, Common Cancers affecting Men & Women (2016-2020). https://www.nrdo.gov.sg/docs/librariesprovider3/default-document-library/scr-2020-infographics_web-release.pdf?sfvrsn=43459b06_0
2 https://my.clevelandclinic.org/health/diseases/8328-breast-cancer-recurrence
Disclaimer:
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GREAT TotalCare is not a MediSave-approved Integrated Shield plan and premiums are not payable using MediSave. GREAT TotalCare is designed to complement the benefits offered under GREAT SupremeHealth.
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Information correct as at 6 April 2023.
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