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Breast cancer affects millions of lives worldwide, causing emotional and physical distress to patients and their families. Among the various risk factors contributing to breast cancer, one of the most prominent is the BRCA gene. The BRCA gene plays a crucial role in maintaining the stability of our genetic material.
BRCA stands for "Breast Cancer Susceptibility Gene." There are two types of BRCA genes, BRCA1 and BRCA2, located on different chromosomes (17q21 and 13q12.3, respectively). These genes encode tumour suppressor proteins that help repair damaged DNA and maintain genomic stability. In essence, they act as "caretakers" of our genetic material, preventing the development of abnormal cells and cancers.
When BRCA1 or BRCA2 genes undergo harmful mutations, they lose their ability to repair damaged DNA effectively. This can lead to an increased risk of breast, ovarian, and other types of cancer. Inherited mutations in these genes are associated with hereditary breast and ovarian cancer syndrome (HBOC), which accounts for a small percentage of all breast cancer cases but tends to have a higher lifetime risk of cancer development.
Carrying a BRCA gene mutation does not necessarily guarantee the development of cancer. However, it significantly elevates the risk compared to the general population. Women with harmful BRCA1 mutations have a 40% to 85% risk of developing breast cancer during their lifetime, while those with BRCA2 mutations face a 45% to 85% risk. Additionally, the risk of ovarian cancer is substantially increased for women with BRCA mutations.
If you have a family history of breast or ovarian cancer, or if you belong to a high-risk ethnic group, genetic testing can determine whether you carry a harmful BRCA mutation. Genetic counselling is recommended before and after testing to ensure a full understanding of the implications of the results and to discuss appropriate risk management strategies.
For individuals carrying harmful BRCA mutations, there are several risk reduction strategies available. These may include increased surveillance with regular screenings, prophylactic surgeries (e.g., mastectomy or oophorectomy), and preventive medications. Decisions regarding risk reduction should be made after thorough discussions with healthcare professionals and genetic counsellors, considering personal and family circumstances.
While BRCA mutations are predominantly linked to breast and ovarian cancer, they may also be associated with an increased risk of other cancers, such as pancreatic, prostate, and male breast cancer. Consequently, BRCA gene testing and risk assessment extend beyond women and encompass men as well.
Ongoing research in the field of BRCA genes continues to shed light on the underlying mechanisms and potential treatment options. Targeted therapies, such as PARP inhibitors, have shown promise in treating certain BRCA-related cancers, providing hope for more effective and personalized treatments in the future.
The discovery of BRCA genes has significantly advanced our understanding of the genetic basis of breast cancer. Genetic testing and counselling have become vital tools in assessing an individual's risk and guiding appropriate risk management strategies. As research progresses, we hope to witness further breakthroughs that will revolutionize breast cancer prevention, detection, and treatment, ultimately leading to improved outcomes and a brighter future for those at risk.