Jen Brand had her first mammogram 10 years ago, when she was 35. Its findings were suspicious, so she was advised to return for a breast MRI six months later. That’s when Brand, who has a family history of breast cancer, got the results she dreaded: She had a 2 cm malignant breast tumor.
She’d never been tested for a BRCA mutation — a genetic abnormality that increases the risk of breast and other cancers — in part because she worried health insurers might balk at the results. Plus, she said, she was focused on launching her career.
“I didn’t really think about it,” said Brand, a Berkeley resident and fundraising professional at UC Berkeley.
After her initial diagnosis, her oncologist recommended further testing. The results came back positive for a mutation in the BRCA2 gene (one of the two BRCA genes), and that diagnosis informed her treatment.
Without that information, “I may have just opted for a single mastectomy,” she said. “Perhaps just a lumpectomy.”
Instead, Brand underwent a double mastectomy with reconstruction, chemotherapy and, later, a total hysterectomy, as BRCA mutations also increase the risk of developing ovarian cancer.
“At that point my kids were 4 [years old] and 14 months. I knew I didn’t want to have anymore kids,” she said. “I didn’t want to mess around.”
A BRCA gene mutation is one of the most common genetic disorders affecting Ashkenazi Jews. It’s present in about one in 40 Jews of Central and Eastern European descent, according to the Basser Center for BRCA at the University of Pennsylvania.
That makes Ashkenazi Jews about 10 times more likely to carry the mutation than the general population. And affected women have up to a 75 percent greater risk of developing breast cancer, according to figures provided by the Basser Center.
On March 28, Congregation Beth El in Berkeley will host a panel called “Knowledge Is Power: Understanding and Managing BRCA-Related Cancer Risk.” Facilitating the discussion will be the Basser Center, whose mission is to eradicate BRCA-related and hereditary cancers and “provide a road map for curing other genetic diseases.”
The panel will address the risks, how to know whether you’re a good candidate for genetic testing, and how to navigate “the challenging decision-making” faced by mutation carriers like Brand, who will be one of the panelists.
The Basser Center is the first comprehensive research and treatment center devoted to BRCA-related cancers, according to its website. It was founded by UPenn alums Jon and Mindy Gray in 2012, a decade after Mindy lost her sister, Faith Basser, to BRCA-related ovarian cancer.
Beth Stearman, the center’s administrative director, said education and panel discussions have been central to the organization’s charter since its founding.
“Part of our mission is to raise awareness of these mutations and educate people about the risk, so they consider talking to genetic counselors and other professionals,” she said. “We very much feel that knowledge is power.”
Everyone has BRCA1 and BRCA2 genes. But in some people, genetic mutations significantly increase the risk of certain cancers, including a lifetime risk up to 50 percent greater than average for ovarian cancer and up to 25 percent for prostate cancer, according to researchers.
Testing isn’t recommended for everyone; experts say good candidates include those who have already been diagnosed with a potentially BRCA-related cancer; Ashkenazi Jews with a family history of breast, ovarian, pancreatic or high-grade prostate cancers; and Ashkenazi Jews with a family member who has a known mutation in a cancer risk gene.
Most people undergo genetic counseling before being tested. If a mutation is detected, doctors say, both surveillance and surgical options are usually considered.
There has been increasing discussion about BRCA testing for all Ashkenazi Jews, according to the Basser Center, a topic likely to come up during the Beth El event.
Stearman said that while the Basser Center often convenes panels at centers of Jewish life, this will be its first event in the Bay Area.
“Because the mutations are so common in the Jewish Ashkenazi population we do a lot of Jewish programming. It’s a natural fit,” she said. “When we have a partner like Beth El that’s really engaged with the community, that makes these programs most successful.”
Brand said she’s committed to being open about her experience if it helps others in their decision-making.
“A lot of people reach out to me when they’ve been diagnosed or have friends who have been diagnosed,” she said. “I’m very happy to share my story with people, for better or worse.”
She recently celebrated her daughter’s bat mitzvah, and is about a year away from finishing her post-surgery hormone treatments. The event coincides with the 10-year anniversary of her cancer diagnosis.
“July will be my 10-year ‘cancerversary,’” she said. “It’s good timing.”