Question 1. Six years ago, cancer was detected in my mother’s right breast. It was treated. Two years ago, she developed cancer in her other breast. While this was also fully treated, this time cancer was seen in his left ovary. He was operated on. He received chemotherapy. Doctors say my mother is now cleared of all cancers. However, we are worried. What should we do next? What is the risk of cancer in my mother and in us as her daughters?
Answer 1. If breast cancer occurs especially at a young age, is seen in both breasts and is associated with ovarian cancer, these cancers are likely to be due to genetic changes. We do not know your mother’s age, but the occurrence of cancer in related organs suggests that they may be of genetic origin. Genetic mutations called brca-1 and brca-2 are responsible for half of familial cancers.
You state that the cancers in your mother were treated. However, only two years have passed since the second breast cancer. If hormone receptors are positive in this breast cancer, that is, if it is sensitive to estrogen hormone, tamoxifen or aromatase inhibitor drugs should be continued for five years. Check-ups should be carried out every three months, and mammography should be performed once a year if all breasts are not removed. For ovarian cancer, the blood tumor marker should be checked at regular intervals. The marker that tends to increase in ovarian cancer is the protein called CA-125. In cases where this is elevated or in any doubt, abdominal ultrasonography, tomography or MR can be taken.
Since breast and ovarian cancers in your mother may have a genetic aspect, it would be beneficial for you to have mammography, breast and ovarian examinations according to your age. We can say that you have an increased risk compared to normal women. The age to start mammograms is 40 for normal women. However, if there are brca-1 and brca-2 mutations, mammography can be started earlier. In fact, MRI and mammography can be applied alternately every 6 months.
If you feel stressed about risk as their daughter, you can have brca-1 and brca-2 mutations checked. Thus, a healthier risk assessment can be made. The risk of developing breast cancer in women with Brca mutation is 45-85%, and the risk of developing ovarian cancer is 15-30%.
Prof. Dr. Coşkun Tecimer
