Can cancer genome testing help manage my breast cancer?

Question

Hello doctor,

I am a 40-year-old woman recently diagnosed with breast cancer. My oncologist suggested cancer genome testing to guide treatment.

How exactly does this testing help?
Does it mean I can avoid chemotherapy if certain mutations are not present?
Will it also tell me about inherited cancer risks for my daughter?
Is the test very expensive, and is it done only once or repeated?

I feel overwhelmed by the amount of genetic information and how it affects my treatment choices.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I am truly sorry that you have been diagnosed with cancer, and of course, I completely understand the fear and panic you must be feeling. It is natural to be worried about the treatment, its side effects, and many other things. But I want to reassure you first that cancer is no longer like it used to be. It is no longer as frightening or overwhelming. There are now many very strong treatment options that help reduce the burden on the patient.

The first step for me is genetic testing. We have two types of genetic tests. One type is done to check whether there is a hereditary gene that you may have inherited from your family and could possibly pass on to your daughters. This is called the BRCA 1 and 2 tests. When we know the result, we can determine the type of targeted therapy we will use with you later on, and it also helps us decide the nature of the surgery you may need, whether we remove only the tumor or remove the whole breast as a preventive measure. And of course, this is completely your choice. If you do not prefer the surgical option, we may rely on hormonal therapy.

As for your daughter, if she reaches 25 years of age and you test positive for BRCA, we recommend that she also undergo the BRCA test so we can choose the most appropriate preventive strategy for her.

The second test is the Oncotype DX, which we perform on the cancer cells themselves to determine how aggressive they are. If the score comes out higher than 26, we give chemotherapy as a form of prevention. But if the score is less than 26, then in that case, we do not need to use chemotherapy. We rely only on surgical treatment, radiotherapy, and hormonal therapy.

The good thing is that you can do the tests through insurance if you submit documents showing that you have a positive family history. If there is no positive family history, you can consider consulting with pharmaceutical companies that conduct clinical trials. You can join a clinical trial, and they will perform the tests for you, help you with the treatment, and provide support in this area as well.

Investigations to be done include Oncotype DX, BRCA 1, and BRCA 2. The treatment plan includes surgery and radiotherapy. Preventive measures include chemotherapy and hormonal therapy. Regarding follow-up, you will need to be checked once every seven days.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.