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Natalie Clauss

Sword of Damocles BRCA

Some time ago, I wrote a post on Instagram about the importance of breastfeeding for us as moms, because breastfeeding has a positive influence on a wide range of diseases. In this context, for example, I mentioned that breastfeeding reduces the risk of breast and ovarian cancer - a topic that is always on my mind.

This will not be a specialist article, but I will write about my thoughts, feelings and experiences. It is not primarily intended to inform. That is not my aim this time.

There are several women in my family who have had breast or ovarian cancer and some have died from it. The chance of survival depends on various factors, especially the time at which the cancer was discovered.

Eine in Händen gehaltene pinke Schleife, als Symbol für Brustkrebs.

There are various early detection options for breast cancer: palpation (your own or gynecological), ultrasound, mammography and possibly MRI. Overall, the prognosis for breast cancer is even more positive than for ovarian cancer.

The signs of ovarian cancer are diffuse and it is often only detected very late. This is what makes it so insidious.

If several women in a family have been diagnosed with breast and/or ovarian cancer, it is usually possible (under certain conditions) to have a genetic test carried out. This is because there are various genes that are associated with an increased risk of developing the disease. These primarily include the mutations BRCA-1 and BRCA-2, where BRCA simply stands for Breast Cancer.

If such a mutation is found, an individual disease risk can be calculated for the respective age based on the family history.

I had this genetic test carried out when I was about 20 years old. I wanted to know for sure whether I should be worried or not. First and foremost, however, I wanted the chance to start early and thoroughly with early detection methods.

As you may already have guessed, a corresponding mutation was found in my genetic test. This didn't have much relevance for me at first, as I was still young. But the thought of cancer was still there, of course. But it would have been there even without the genetic test. After all, you can't simply ignore the fact that three people you love suddenly develop cancer.

After the birth of my first child, I was given the opportunity to take part in a study for BRCA carriers. As part of the study, an MRI scan of the breast is carried out regularly. This is probably much more informative than a mammogram before the onset of the menopause. In addition, a breast ultrasound should now be carried out regularly in addition to palpation examinations. I was also able to have my ovaries examined by ultrasound as required.

Aufnahme eines MRT-Geräts.

In addition, just yesterday I read the report of a new study on a drug that can be given prophylactically to BRCA-1 carriers as an alternative to removing the breast tissue. Of course, more research is needed here, but something is happening. Vaccination is also always on the agenda.

I'm curious to see what else will happen here in the next few years. At the same time, it will probably all be too late for me. I want to think now about how I can deal with the risk of cancer over the years. What has been recommended to me is a prophylactic removal of the ovaries and breast tissue. There remains a small residual risk, including for other types of cancer, but overall this is hardly present with the removal, as I understand it so far.

I am currently 31 years old. After having a nightmare tonight in which I had cancer, I have just looked at the table again with the respective percentages of the risk of developing the disease. Currently just under 4% for breast cancer and under one percent for ovarian cancer. But the risk is rising fast, to over 70% for breast cancer and over 40% for ovarian cancer.

It seems as if these figures are hovering over me like a sword of Damocles, and with it the risk of cancer.

But what is this sword of Damocles all about? I actually looked it up recently.

Aufnahme eines an einer Wand stehenden Schwertes.

The sword of Damocles is the symbol for a danger or threat that is constantly hovering over you. The legend was passed down by Cicero, whereby Dionysus I of Syracuse served his courtier Damocles a sumptuous meal, over whose head he had a sword hung from a horse's hair to show him the constant threat to any happiness, according to Wikipedia. However, it is not certain whether Damocles actually lived.

But back to the topic.

The subject of cancer is not always on my mind. It varies greatly how often I think about it and how I feel about it. When I watch series or movies in which a person is diagnosed with cancer, or when I hear about a disease in my environment, I quickly start thinking about it myself.

Yes, I'm still young now. Yes, maybe I still have time. But I don't want to die. I don't want to leave my family alone. Yes, it's still just a number, a relatively low number. And yet the thought just keeps coming back.

Sometimes I wake up crying. Or I cry during movies. It can be very stressful to imagine your own death like that. Talking about it helps. It helps to write down your thoughts and let your feelings out. But the sword of Damocles remains.

Aufnahme von zwei rosa Luftballons, welche in Händen gehalten werden.

And so I keep thinking about when I want to tackle something. Removing the mammary gland tissue after this third, my last breastfeeding period, currently seems logical to me. A fourth child is definitely not an option under these conditions (also for other reasons), so removing the ovaries would also be possible.

But the decision to remove the glandular tissue is not the end of the story. There are various opteration techniques, the possibility of a breast reconstruction afterwards and the like. Topics that I have no idea about. I will certainly seek further advice on this over the next few years.

It's no fun dealing with it. It's always a burden. But this latent fear is also a burden. It really isn't always easy. And I wish so much that I hadn't passed this genetic mutation on to my daughters (and also to my son).

So much for this point. Now the article has become much more factual than I thought it would be when I started it. But that's okay too. I hope I've been able to give you a little insight into my thoughts and feelings on this subject.

Perhaps you also have the same genetic mutation and have similar thoughts? If you like, you can write to me about it. And even if you don't have BRCA, you might like to write something about my thoughts.

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