real life

"The BRCA breast cancer test is more than just a medical test... it's life changing."

It’s like something from a science fiction novel, isn’t it?

Genius scientist discovers a way to detect breast cancer before it even happens. Girl faces decision for rest of her life to ignore the results, or sacrifice part of her body in a bid to save it.

It’s a moral dilemma, an emotional roller coaster, a quandary so modern and so strange it sticks with you for weeks.

Unfortunately, it’s not the work of fiction but a very, very real choice that women like me have been stuck with in recent years.

So, if you could know if the heartache of breast cancer awaits… would you?

Would you want to know if you had the BRCA gene mutation? (Image: iStock)

Eight years ago, I lost my aunt to breast cancer.

As a close-knit family, the loss was felt deeply by all of us. The shock of finally losing her after such a long journey of fighting and remission, fighting and remission - well, it was exhausting. I was 21. I hadn't watched anyone die before.

It was a pain that took many years to get a handle on, and still stings today. Making it worse is the knowledge breast cancer haunts both sides of my family, claiming an aunt on Dad's side and almost taking my maternal grandmother.

Throw in multiple sclerosis, Parkinson's disease, and bowel cancer in my immediate family into the mix and you have what my mother refers to as a 'genetic swamp'.

So, it's sort of been an unspoken understanding between my siblings and I that one day, and one day soon, we would need to begin some pretty extensive precautionary measures to protect ourselves against hereditary diseases.

But while we assumed that cameras down our throats (endoscopy), cameras up our bums (colonoscopy), and a few squished boobs (mammogram) were the worst we were looking at; we never saw the BRCA test coming.

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Mammograms were as far as I though breast cancer screening would go in my lifetime.

So, the BRCA test: what is it? And how the heck is it possible?

The BRCA test is a genetic screening that detects a mutation in the tumor suppressing genes BRCA1 and BRCA2. According to Cancer Australia, the existence of a mutation in either of these genes means a high lifetime risk of developing breast cancer (30 to 60 per cent), and a high lifetime risk of ovarian cancer, too (20 per cent).

Not great stats.

It is easy to understand, therefore, why women who test positive to the gene mutation opt for a double mastectomy (breast removal) and/or bilateral salpingo-oophorectomy (removal of the ovaries and fallopian tubes).

When Angelina Jolie had both her breasts removed after testing positive to BRCA in 2013, and then her ovaries in 2015, she was clear in her reasoning.

“I feel feminine, and grounded in the choices I am making for myself and my family," she said to The New York Times.

"I know my children will never have to say, ‘Mum died of ovarian cancer.'”

Sydney Breast Clinic, on breast screenings. (Post continues after video)

And despite the brave resolve of high profile advocates such as Jolie, and the thousands more of non-high profile women who have also had to make this choice, it is still one that looms large when you're only 28.

Your breasts, your ovaries - they are central to your sense of womanhood. What a strange thing to consider losing.

There are many thoughts that run through your head when considering the testing: what would I do if it came back positive? Would I run the risk of not having the operation?

What would my aunty have done, should she have had the choice? Is it better to live a happy life in ignorance, or make a confronting discovery that might one day save my life?

Or, even harder again, what if it comes back negative, and we think we're immune to ever getting sick. That seems most dangerous of all: foolhardy ignorance.

Over the years I've worked a fair bit in a fairly niche industry known as 'futurism'.

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Basically, it road tests current policies, laws, and strategies against future situations.

For example, a car insurance company needs to consider the fact that driverless cars are likely to dominate the roads in 100 years time. It's sticking your head into the world of science fiction and seeing what you can find.

So, moral dilemmas are something of a specialty to me. If programming a driverless car, who do you swerve to hit, the old lady or the woman with a pram? In a world of international politics, what's more democratic, a human or artificial intelligence?

But when it is you, and your health, and your family on the line; this kind of moral dilemma feels almost impossible to answer.

Perhaps if I hadn't watched my wonderful aunt battle such vicious cancer for such a long time, I wouldn't feel so strongly about the BRCA testing. I'd probably shrug it off as I have with other things like laser eye surgery, and just think it 'wasn't for me'.

But I did. And I do know. And at 28, no longer at an age when you feel invincible (I see you, wrinkles!) it's hard to ignore the grim possibility that I may too have inherited the terrible flaw of BRCA mutations.

I don't know what I'll do. But it is interesting to sit on the cusp of a very strange and interesting chapter in modern medical history. Once where we can, quite literally, take a glimpse into our future, and make changes today that might save our lives.

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