What is a Previvor?

While I treat breast cancer every day, discuss genetic testing and make recommendations regarding preventative surgery, the term “Previvor” was quite new to me.  I received a Facebook post from a friend who had just gone through a prophylactic double mastectomy.  In her post, she stated, “I am now a previvor!”.

Seeing your healthy friend go through this kind of surgery can be frightening.  It is important that we understand genetic mutations and support those who wish to be preventative with their health.

Earlier this month was National Hereditary Breast and Ovarian Cancer Week and October 2nd was National Previvor Day.  These days bring awareness to hereditary breast and ovarian cancers, and the week is sponsored by the organization FORCE (Facing Our Risk of Breast Cancer Empowered).  There are millions of people who carry a breast cancer gene or have a family history of cancer but do not know their risk.

The average woman faces a 13% lifetime risk of developing breast cancer.  The majority of breast cancers occur after age 60.  Women with a BRCA1 or BRCA2 mutation have a much higher lifetime risk for breast cancer, and much of the risks occur at a younger age.  These mutations also increase the risk of breast cancer in men.  These mutations also may increase the risk of other cancers, such as, ovarian cancer, prostate cancer, colon cancer and pancreatic cancer.

There are other genetic mutations increase breast cancer risk for women, and we are learning more and more about genetics every day.  Research in this area helps us to develop more targeted treatments for breast cancer.

How do you know if you have a breast cancer gene?  In general, younger women with breast cancer or breast cancer patients with a family history in first degree relatives are candidates for genetic testing.  The affected patient is usually tested first.  If you have a relative with a breast cancer gene, then you are a candidate for testing.  If you have a strong family history of breast cancer, you should ask your doctor if you should see a genetic counselor.

Many people will ask if they need a double mastectomy if they have a BRCA mutation.  While this topic is controversial in the medical literature, many women will choose this option to lower their breast cancer risk to about 4%.  Insurance companies will almost always cover prophylactic mastectomy and reconstruction if a patient carries a genetic mutation.