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Speaker 1: Brought to you by the reinvented two thousand twelve Camray.

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Speaker 1: It's ready. Are you welcome to stuff Mom never told you?

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Speaker 1: From House Towards dot com. Hey there, and welcome to

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Speaker 1: the podcast. This is Kristen and Mrs Molly. Molly. Breast

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Speaker 1: cancer has been in the news a lot this week

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Speaker 1: and it's heartbreaking news, honestly. Um. There was a ten

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Speaker 1: year old Hannah pale al Slam who was diagnosed with

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Speaker 1: breast cancer, and then there was some follow up news

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Speaker 1: of an eight year old girl who was diagnosed with

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Speaker 1: ovarian cancer, and it really caught a lot of women's

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Speaker 1: attention because we think of breast cancer ovarian cancer is

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Speaker 1: something that really affects people maybe our mother's age, um,

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Speaker 1: but it is in fact something that can happen to

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Speaker 1: two girls this young. So that kind of got me

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Speaker 1: thinking about breast cancer and why so prevalent among women,

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Speaker 1: and um, what else is going on with with prevention?

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Speaker 1: Right And at the same time that all of this

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Speaker 1: uh sad news was coming out, there were also reports

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Speaker 1: that the a c l U had UH sort of

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Speaker 1: organized a lawsuit against MARYA Genetics, which holds the patent

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Speaker 1: on the breast cancer genes breast cancer gene one and

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Speaker 1: breast cancer gene two, which from here on out we're

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Speaker 1: just gonna say Braca. UM. The lawsuit challenges the patents

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Speaker 1: that this company holds on these two genes, which occur

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Speaker 1: naturally in the body. UM about of human genes are patented,

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Speaker 1: so they're not the only ones that have patents, but UM,

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Speaker 1: since married was the first to sequence this gene, they've

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Speaker 1: had this patent on it for a few years. And

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Speaker 1: a CLU says this is unconstitutional, right because Mary Genetics

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Speaker 1: has used UH this patented gene in order to develop

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Speaker 1: testing for BROCA there it's the only company right now

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Speaker 1: that is legally allowed to conduct testing for Brocco one

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Speaker 1: and Broca two and UH. The a c l U

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Speaker 1: is concerned about quality assurance and whether or not more

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Speaker 1: competition in the marketplace would lower the cost barrier and

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Speaker 1: all those factors surrounding it, because breast cancer is so

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Speaker 1: prevalent among women, right and especially these you know you

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Speaker 1: were talking about how you're concerned, especially about younger women,

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Speaker 1: and I think that they're the ones who would be

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Speaker 1: most interested in getting a genetic test to find out

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Speaker 1: if they are carriers of Brocco one and Broca too. Basically,

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Speaker 1: you can have a blood test, they'll sequence the your

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Speaker 1: DNA and if you carry an altered form of this gene,

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Speaker 1: then your chance is just skyrocket that you will have

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Speaker 1: breast cancer. Uh. You know, all women walking around today

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Speaker 1: in the world, there's a thirteen percent chance of breast cancer.

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Speaker 1: But if you're carrying this gene, you're three to seven

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Speaker 1: times more likely to developed breast cancer. And what's striking

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Speaker 1: about it is with this gene, you don't get an

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Speaker 1: old age. You get it long before menopause. Right, Um,

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Speaker 1: Because you're as you age, your chances for for breast

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Speaker 1: cancer steadily increases to where when you hit fifty you

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Speaker 1: have a one in fifty chance of developing breast cancer.

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Speaker 1: But like you said, if you are a Bracca car carrier,

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Speaker 1: there's a much higher chance that you will develop it

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Speaker 1: long before menopause. So let's talk a little bit more

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Speaker 1: about what this gene test entails and who all should

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Speaker 1: get it, because not every female should just walk into

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Speaker 1: the doctor's office and ask for the Brocca gene tests. Right.

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Speaker 1: It's too expensive to do that, um. And basically it's

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Speaker 1: not like all the can't breast cancer in the world

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Speaker 1: is caused by Bracca. Of the about a hud American

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Speaker 1: women learn their breast cancer each year, only five to

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Speaker 1: ten percent of those cases are hereditary, which would mean

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Speaker 1: that they had a gene that caused the disease. So

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Speaker 1: the Brocca gene test is reserved for women who would

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Speaker 1: be in these higher risk groups. And uh women for instance,

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Speaker 1: who might who might be more risk for having this

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Speaker 1: gene mutation would have a personal breast cancer diagnosis, a

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Speaker 1: family history of breast cancer at a young age, and

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Speaker 1: two or more close relatives, a family history and more

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Speaker 1: than one generation a male relative with breast cancer, because well,

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Speaker 1: we can't forget that while it is rare, men can

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Speaker 1: develop breast cancer as well. Um a family member bilateral

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Speaker 1: breast cancer as in breast cancer in both of the

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Speaker 1: breast um, and a family member who has both breasts

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Speaker 1: and a variant cancers and women of Eastern European Jewish ancestry, right,

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Speaker 1: So those are the high risk groups. And if they

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Speaker 1: so choose, a lot of people don't really want to know.

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Speaker 1: You know, essentially, you know, you find out interesting things

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Speaker 1: about your d n A if you choose undergo genetic testing,

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Speaker 1: you're basically finding out things you know you might have

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Speaker 1: a getting. You could go in and find out your

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Speaker 1: carrier for this gene or you're not, which is already

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Speaker 1: going to cause some maybe drama and your family if

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Speaker 1: you know your sisters a carrier and you're not. But

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Speaker 1: then you've got to decide if I am positive for

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Speaker 1: this gene, what am I going to do about it?

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Speaker 1: Because it's not just because you carry this gene, it's

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Speaker 1: not a guarantee you are going to have cancer, right,

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Speaker 1: It just means that you have a much higher risk

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Speaker 1: probably for developing breast cancer or ovarian cancer. And one

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Speaker 1: of the things that the Mayo Clinic really urges women

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Speaker 1: who are thinking about getting the gene testing is to

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Speaker 1: meet with a genetic counselor and really go over the

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Speaker 1: potential psychological impacts of getting genetic testing, because, like you said,

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Speaker 1: I mean, if you find out that you are a

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Speaker 1: carrier of this mutation, you are then going to have

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Speaker 1: to make some very tough decisions about your body, right Christen,

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Speaker 1: So let's let's talk about like, let's say you get

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Speaker 1: the positive test result that you have the Brocka gene,

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Speaker 1: what are your options. Let's go over those real quick, okay, um.

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Speaker 1: The first thing that you can do, which is I

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Speaker 1: guess the least invasive step that you could take would

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Speaker 1: just be increased screening. You might bump your clinical breast

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Speaker 1: exams to every six months and having mammograms every year,

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Speaker 1: and your doctor might actually recommend that you have breast

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Speaker 1: m r eyes, which are more detailed look inside of

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Speaker 1: the breast to to keep a um keep a closer

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Speaker 1: watch on whether any cancer could be developing. And then

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Speaker 1: at the other side of the spectrum, probably the most

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Speaker 1: invasive thing you could do would be to remove essentially

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Speaker 1: all your breast tissue in order to reduce the chance

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Speaker 1: that a tumor would develop in that tissue. So basically

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Speaker 1: you'd have a profanitive bassectomy um and this would reduce

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Speaker 1: your breast cancer risk by about um. And then you

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Speaker 1: also have an option of removing healthy fallopian tubes and ovaries,

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Speaker 1: which would reduce your breast cancer risk by about and

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Speaker 1: reduce your risk of developing ovarian cancer by about But Molly,

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Speaker 1: those are those are pretty extreme surgeries to make before

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Speaker 1: you even know that you have surgery. In this article

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Speaker 1: that we were reading in the New York times of

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Speaker 1: kind of tracking This um thirty year old woman's decision

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Speaker 1: to have a preventative mess sack to me, really gave

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Speaker 1: insight into um, how much you have to think about,

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Speaker 1: like what kind of a burden it is like talking

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Speaker 1: to your family about it. This woman, UM had a

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Speaker 1: pretty strong family history of breast cancer. Her mother had

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Speaker 1: breast cancer. She watched her go through chemotherapy, and she

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Speaker 1: was just terrified that she would have to go through

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Speaker 1: the same thing and ended up choosing to get the

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Speaker 1: preventative mestick to me, but it certainly wasn't you know,

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Speaker 1: an easy decision to come to rite part of the

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Speaker 1: thing you're gonna have to consider, especially if you're at

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Speaker 1: that young of age. I believe she was thirty three

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Speaker 1: and she was unmarried. Uh. You know, women have a

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Speaker 1: lot of issues tied up in their body about what

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Speaker 1: makes them attractive, what makes them you know, essentially feminine,

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Speaker 1: and your breasts and your ability to have children are

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Speaker 1: two of those main things. So she was dating a

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Speaker 1: guy at the time. I was trying to sort of

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Speaker 1: uh sess out how he felt about plastic surgery, and

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Speaker 1: you know, if she would have breasts that weren't real

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Speaker 1: that wouldn't be able to breastfeed one day. So it's

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Speaker 1: a very loaded decision to have to make based on

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Speaker 1: a you know, based on a test result that doesn't

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Speaker 1: say necessarily you're gonna have cancer, but it does say

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Speaker 1: you have an extremely high chance of having cancer. And

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Speaker 1: there is one other option. It's called chemo prevention, which

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Speaker 1: is basically where you start taking the drugs that you

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Speaker 1: would take if you were undergoing breast cancer treatment as

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Speaker 1: sort of a preventative measure, and then maybe one day

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Speaker 1: they hope that they will be able to do gene

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Speaker 1: therapy perhaps alter these genes. But this gets back to

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Speaker 1: why there might be a patent on this, uh, because

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Speaker 1: what can happen sometimes when you have this test is

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Speaker 1: instead of getting the positive or the negative, you have

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Speaker 1: an ambiguous result. Right. Um, there was a study that's

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Speaker 1: found that about ten of women undergoing bracket testing had

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Speaker 1: ambiguous or uncertain test results. They don't know whether it's

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Speaker 1: positive or negative. So that just kind of leaves them

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Speaker 1: back the drawing board. So in that case, you know,

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Speaker 1: for any other medical procedure where you get sort of

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Speaker 1: a you know, ambiguous result, you'll be able to have

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Speaker 1: another test. But that's sort of the problem. One of

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Speaker 1: the problems at heart of this A c l U

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Speaker 1: lawsuit is because Mary Genetics is the only company that

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Speaker 1: has this has the right to administer this test, there's

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Speaker 1: no sort of second opinion available to women, and Mary

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Speaker 1: Genetics are the only labs that are legally allowed to

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Speaker 1: to perform the testing. And while there haven't been any

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Speaker 1: studies that have said that uh, other labs doing kind

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Speaker 1: of backup testing would improve um the rate of false

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Speaker 1: positives and false negatives. UM, the A c l you

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Speaker 1: thinks that it should still be an open option, right,

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Speaker 1: they should be able to get that second opinion. Or

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Speaker 1: let's say, you know a lot of women go in

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Speaker 1: and their concern based on their family history, they're convinced

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Speaker 1: they have this gene and then they get a negative

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Speaker 1: almost like you still can't believe it until you have

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Speaker 1: some sort of further proof, right, and even if you

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Speaker 1: get a negative, we can't forget that, uh, no matter

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Speaker 1: what every woman has about a chance brockagene or no

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Speaker 1: brockagene of developing breast cancer. So just to review, now

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Speaker 1: that we know why you might want to take this test,

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Speaker 1: and no sort of your odds and your options. We'll

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Speaker 1: just go over real quick again, why it would matter

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Speaker 1: if this gene had a patent obviously, Uh, you know,

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Speaker 1: the treatment for breast cancer is very extreme. It's hard

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Speaker 1: on the body. Obviously, people think that if you know

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Speaker 1: what the breast cancer gene is, you can do a

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Speaker 1: lot of work in terms of research of prevention and cure.

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Speaker 1: And right now Myriad is basically sitting on this gene.

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Speaker 1: They're probably doing their own research, but a lot of

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Speaker 1: scientists would like to get in on that action, right

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Speaker 1: And Molly didn't didn't you read an article and CNN

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Speaker 1: that was saying that that even though a lot about

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Speaker 1: of sequenced genes are patented, the court kind of sillocking

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Speaker 1: this as its test case. That's where what a lot

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Speaker 1: of legal scholars think is that you know, because you

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Speaker 1: know so many women are affected by this, and you

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Speaker 1: know men have lost the spouse to this, daughters to this,

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Speaker 1: that why wouldn't you open up the breast cancer gene

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Speaker 1: when when breast cancer is so prevalent um and and

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Speaker 1: just to go over those stats again, um cancer and

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Speaker 1: younger women under thirty is rare, accounting for about one

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Speaker 1: and a half percent of all breast cancer cases. But

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Speaker 1: then at the age of forty our chances go up

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Speaker 1: to one and two. By fifty we've got a one

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Speaker 1: in fifty chance, and if we live to be eighty five,

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Speaker 1: the odds of developing breast cancer are one in eight.

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Speaker 1: So it's pretty staggering. This case is definitely wanted to

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Speaker 1: keep an eye on. We don't know how it'll shake out,

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Speaker 1: and you know who have the issue. Thing here is

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Speaker 1: also priced. They don't know if the price of the

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Speaker 1: exam would be lowered by competition on the market, but

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Speaker 1: for reasons of that quality assurance for the research. That's

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Speaker 1: why the a c l U is saying that people

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Speaker 1: should have the ability to have access to to a

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Speaker 1: gene that is already in their body. Right, Molly and

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Speaker 1: I think that if we were talking about breast cancer,

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Speaker 1: even if you aren't in the high risk group and

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Speaker 1: might want to consider getting the Brocka gene testing, I

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Speaker 1: think that it is worth mentioning that women in our

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Speaker 1: twenties and thirties should have a clinical breast exam as

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Speaker 1: part of a periodic health exam by health professional, preferably

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Speaker 1: every three years, and after forty that breast exam should

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Speaker 1: happen every year in addition to mammograms. Because a twelve

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Speaker 1: percent chance Molley is nothing that you want to gamble with.

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Speaker 1: Question not so. If you want more information on breast

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Speaker 1: house stuff works dot com. And if you have any questions, comments,

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Speaker 1: or suggestions for me and Molly, we'd love to hear

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Speaker 1: from you. You can send us an email at mom

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Speaker 1: stuff at how stuff works dot com for more on

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Speaker 1: this and thousands of other topics. Because at how stuff

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Speaker 1: our logs on the house of boards dot com home page.

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Speaker 1: It's ready, are you