BRCA risk management
If you have an altered BRCA gene, information and support can help you to adjust to the news and approach decisions about risk management and possibly fertility.
What can I do to manage my risk?
If you have an increased risk of cancer due to an altered BRCA gene, your genetic counsellor and hospital team will talk through the options available to you to help manage your risk. These may include:
- Surveillance - tests to monitor your health. Surveillance tests don’t reduce the risk of cancer developing, but they can spot cancer at an early stage, when it is easier to treat.
- Medication to try to stop cancer developing. You can have medication along with surveillance tests.
- Surgery to remove your breasts/ovaries before a cancer develops.
The type of risk management and when your risk management plan starts will depend on your age, the gene affected and your own preferences.
BRCA risk management options
Surveillance does not prevent cancer. It involves tests designed to spot cancer at an early stage.
- Breast exam by a doctor or advanced nurse practitioner every 6-12 months from age 30
- MRI scan of your breasts every year from age 30. Usually stops around age 50 unless you have very dense breasts. If you have dense breasts, MRI may continue to age 55.
- If you have a family history of breast cancer at a young age, MRIs may start at age 25
- Mammograms (breast X-rays) every year from age 40 to 70.
- Taking an anti-hormonal (endocrine) medication every day for 5 years to reduce the risk of developing breast cancer.
The choice of medication will depend on whether you have been through the menopause or not.
- Removing both breasts (bilateral mastectomy).
- You can choose to have breast reconstruction surgery if you wish.
Ovarian cancer
- Bilateral salpingo-oophorectomy – removing the ovaries and fallopian tubes.
Surveillance is not recommended for those with an increased ovarian cancer risk, as there is no proven benefit in improving survival.
Prostate cancer
Tests with your GP once a year. These are surveillance tests, designed to spot cancer at an early stage. They do not stop cancer from developing.
- PSA blood test
Checking the level of the prostate-specific antigen (PSA) protein in your blood. - Digital rectal examination (DRE)
Inserting a gloved finger into your back passage to see if your prostate feels normal. It can be a little uncomfortable, but it doesn’t take long.
Take care of yourself
Remember that no option reduces your risk to zero and like anyone else, you have a risk of getting another cancer that is not related to a BRCA alteration. As a result, it’s important to take part in screening and report any changes in your body to your GP.
Clinical trials
Clinical trials are research studies that look at new ways of managing disease to see if they are more effective that standard care. Ask your hospital team if there are any clinical trials suitable for you as part of your risk management options.
Deciding what to do
If you have to make choices about managing your cancer risk, you may feel you need to decide what to do straight away, but there is no rush.
Take time to:
- Understand your options
- Think about the benefits and disadvantages
- Decide what may be best for you and when
Your hospital team will make a plan for you when you have made your decision.
More information on BRCA risk management options
Talk to your hospital team
If you need more information and advice, you can talk to your specialist nurse/treating team at your hospital or breast care centre.
Talk to our cancer nurses
Call our Support Line on Freephone 1800 200 700 or call into a Daffodil Centre to talk to our cancer nurses.
BRCA Decision Aid
The BRCA decision aid site from St James’s Hospital has more information on the different options.
It also has a tool to help you decide which option may be best for you.
Talk to a Cancer Nurse
Support Line
Our Cancer Nurses offer confidential advice, support and information for anyone affected by cancer. Call or email supportline@irishcancer.ie. Video calls available. Mon-Fri: 9am-5pm
Our Daffodil Centres
Our Daffodil Centres in 13 hospitals nationwide are staffed by Cancer Nurses and trained volunteers who provide face-to-face advice, support and information for anyone affected by cancer.
