Is a BRCA1 Gene Mutation Worthy of Physical Mutilation?

A famous actress, mother and philanthropist’s recent announcement that she had a double mastectomy as a preventive measure against breast cancer has everyone wondering what her true risks were and whether her decision was warranted or extreme. Please let me say I very much respect her decision and her desire to protect herself out of love for her children. Any decision related to cancer and other health matters is highly personal. There are no “right” or “wrong” decisions. I applaud her for taking control of her health and making the decision which was right for her. I also strongly encourage other women to do thorough research before making a similar decision.Woman performing a breast exam

Her decision was reportedly based on her family history of breast cancer (her mother died at age 57 after battling the disease for a decade) and the fact she was tested for and told she has a mutation in the BRCA1 gene.

What are BRCA1 and 2 Gene Mutations?

In their normal state, the BRCA1 and 2 genes help stop abnormal cell growth. They provide a natural form of protection against breast cancer. When these genes are mutated – typically by environmental toxins and other lifestyle factors, not solely heredity – they stop providing the protection they were designed to. If left unchecked, this may lead to an increased risk of breast cancer. If is important to note that only 2% of breast cancers result from a BRCA1 or 2 gene mutation, and that less than 0.25% of the population has such mutations. While researching this article, I spoke with and read quotes from multiple MDs and surgeons who are frustrated that many women are getting elective double mastectomies who do not have the BRCA1 or 2 gene defect.

Why Preventive Mastectomies Often Fail

Unfortunately, the following factors may make the decision to have a preventive mastectomy an extreme measure offering little or no protection:

  • Only 2% of breast cancers involve BRCA1 or 2 genes; and approximately only 0.25% of the general population has the mutation.
  • Women who had preventive mastectomies often get breast cancer in spite of having little or no breast tissue. Tumors form where breast tissue was previously.
  • Women who have preventive mastectomies often believe they are “safe” and therefore fail to make simple lifestyle changes that greatly reduce their risk of developing breast cancer.
  • Genes are activated and inactivated by environmental and lifestyle factors. Having the gene may statistically increase the likelihood of cancer developing, but it is not guaranteed and the likelihood can be diminished.
  • One study found the risk primarily increased when women with a BRCA1 or 2 gene mutation had their breasts exposed to radiation – such as that from a mammogram. This is significant because women with known BRCA1 or 2 gene mutations are often advised to get a mammogram every three to six months. Although this recommendation is intended to help, the excess exposure to radiation can be very harmful.
  • An article published in 2011 in The Journal of the American Medical Association reported the link between the BRCA genes and breast cancer was grossly overstated. The study found that preventive surgery, at best, may only add 3-6 years of life. This low gain in life expectancy exists because preventive surgery does not provide 100% protection from breast cancer, offers no protection from other cancers, and provides no protection against other causes of death.

What Are Other Options?

The cancer industry in the US treats cancer as an “inevitable” disease that cannot be prevented instead of encouraging people to live in a way that reduces the likelihood of cancer developing. The following tips for preventing and reducing the likelihood of developing breast cancer are based on scientific data and research:

  • Cancer Prevention TipsHave thermograms done to check for breast abnormalities and tumors instead of mammograms. Thermograms are an alternative form of scan with significantly lower risks and radiation exposure. Thermograms are also known to provide higher levels of detection.
  • Eat your veggies. Several studies proved cruciferous vegetables contain a phytochemical which actually turns off mutated BRCA genes. This study found as little as one serving per day of cruciferous vegetables greatly reduced cancer risks. Indole-3-Carbinol (IC3) in broccoli has also been shown to reduce the activity of the BRCA genes.
  • Get out in the sun. Multiple studies have identified a connection between breast cancer and low Vitamin D levels. A study done in 2009 determined 30% of breast cancers could be prevented if men and women would maintain adequate Vitamin D levels. (On a side note, a more recent study which concluded Vitamin D was of no benefit cannot be trusted because the study used a flawed protocol. The study did not use a high enough dosage of Vitamin D to make any difference in health outcomes.) One cancer study estimated that as many as 600,000 cases of breast cancer each year could be prevented if adequate Vitamin D levels were maintained. Vitamin D plays a powerful role in genetic expression and is also known to cause the death of cancer cells. Its value in treating and preventing breast cancer should not be underestimated. (It has been proven beneficial in preventing over 16 different cancers. Are your levels adequate?)
  • Maintain normal weight and insulin levels. It is commonly recognized that obesity and insulin resistance (resulting in excess amounts of insulin in the bloodstream) are connected to breast cancer. Eating a diet low in high-glycemic carbohydrates can help with weight maintenance and may help improve insulin resistance. Regular exercise is also known to reduce the likelihood of developing cancer.
  • The American Institute of Cancer Research estimates that about 40% of breast cancer cases in the US – or approximately 70,000 cases per year – could be prevented using simple lifestyle changes such as making better food choices, exercising more, and choosing a diet high in natural foods. Some experts think these numbers are actually a low estimate and that significantly more cases of breast cancer could be prevented by improved lifestyle habits.
  • Consume adequate amounts of Omega-3 fatty acids and limit intake of Omega-6 fatty acids. Multiple studies have shown a connection between Omega-3 fatty acid deficiencies and breast cancer. These studies also found higher rates of breast cancer among women who had excess levels of Omega-6 fatty acids compared to their Omega-3 levels. Good food sources of Omega-3 fatty acids include wild salmon, chia seeds, walnuts, sardines, olive oil, hemp seeds and eggs. Taking an Omega-3 fatty acid supplement is also a valid option. I prefer Krill Oil due to its purity and because its fatty acid content provides other benefits.

As I stated previously, decisions related to health are very personal. I encourage you to do extensive research before making extreme choices.

References:

BRCA Genes In Breast Cancer Chemoprevention, Eliot Rosen, National Institutes of Health

High Penetrance Breast and/or Ovarian Cancer Susceptibility Genes, National Cancer Institute, 3/4/2013

BRCA1 and BRCA2 as molecular targets for phytochemicals, British Journal of Cancer

Research Interests, Donaldo Romangolo, Bio 5 Institute, University of Arizona

Comparison of Effect Sizes Associated With Biomarkers Reported in Highly Cited Individual Articles and in Subsequent Meta-analyses, John P. A. Ioannidis, MD, DSc; Journal of the American Medical Association, 2011;305(21):2200-2210. doi:10.1001/jama.2011.713

Vitamin D for cancer prevention: global perspective; Garland, C.F., et al. 2009

Vitamin D and prevention of breast cancer: pooled analysis; Garland, C.F., et al. 2007

Estrogen and Insulin Crosstalk: Breast Cancer Risk Implications. The Nurse Practitioner. 2003

Evaluation of the synergistic effect of insulin resistance and insulin-like growth factors on the risk of breast carcinoma. Cancer. 2004

Opposing effects of dietary n-3 and n-6 fatty acids on mammary carcinogenesis: The Singapore Chinese Health Study. USC/Norris Comprehensive Cancer Center, 2003

Regulation of tumor angiogenesis by dietary fatty acids and eicosanoids. Division of Nutrition and Endrocrinology, American Health Foundation. 2000

Graphics: All graphics in this post courtesy of Tips Times

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Dr. Pamela Reilly is a Naturopathic Physician dedicated to helping people improve their health and eliminate symptoms using natural, integrative methods. She has over 25 years of experience and has helped men, women and children improve their health using a holistic, client-centered focus. She sees clients in Indianapolis, does house calls, and also conducts consultations via Skype or telephone. Please feel free to contact her or visit her Consultations page for more information. Dr. Pamela speaks nationwide on a wide variety of health topics and welcomes speaking invitations.

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