Risk Management Options for BRCA Carriers

How can carriers manage their risk of developing cancer?

BRCA carriers can reduce their risk of developing cancer via risk reducing treatment and lifestyle changes. An overview of some of these options are given below:

Lifestyle changes: Eating a healthy well-balanced diet, doing regular exercise, maintaining a healthy weight, reducing alcohol intake, and not smoking can all reduce your risk of developing cancer.

Cancer screening: Having regular screening such as mammograms and MRI scans can help to detect and diagnose cancer at its earliest stages, giving you the best possible prognosis. The type of screening, when it starts and how often you have it will depend on the type of cancer you are at risk of developing.

Risk reducing surgery: Surgical treatment options such as Prophylactic bilateral mastectomy (having both breasts removed) and prophylactic bilateral salpingo-oophorectomy (removal of both ovaries and fallopian tubes) both massively reduce the chance of developing cancer

Medication: Taking come chemo-preventative drugs such as Tamoxifen have been shown to reduce the risk of breast cancer development in female BRCA carriers

What are the options for BRCA carriers who are planning a family?

Some male and female BRCA carriers may opt to use a process called Pre-implantation Genetic Diagnosis (PGD) to ensure that they do not pass on their mutated BRCA gene to their children.

PGD involves undergoing the fertility treatment IVF (In-Vitro Fertilisation), but with the extra step of genetically testing the embryos before they are implanted back into the womb. Only the embryos which have not inherited the mutation are implanted. BRCA carriers who are interested in this option can discuss it with their genetic counsellor or clinical geneticist.

In addition, female mutation carriers who are considering risk reducing surgery should consider the timing of this in relation to their childbearing. Again, this is something that should be discussed with a genetic counsellor.