If you are concerned about your breast health, you may have heard of the BRCA gene and its connection to breast cancer. BRCA1 and BRCA2 are genes that produce proteins responsible for repairing damaged DNA. When these genes function properly, they help prevent cancer by maintaining the stability of genetic material in cells. However, mutations in these genes can significantly increase the risk of developing breast and ovarian cancer.
At Executive Plastic Surgery, Dr. Khan specializes in breast implant removal and reconstruction for women who are concerned about their breast health. This article explains the role of genetic testing and how it may impact your decision-making regarding breast implants.
What is the BRCA gene?
The BRCA (BReast CAncer) gene refers to two specific genes, BRCA1 and BRCA2, that play a crucial role in suppressing tumors and repairing DNA damage. When functioning correctly, these genes help maintain healthy cell growth. However, inherited mutations in either of these genes can lead to an increased risk of breast, ovarian, and other cancers.
Women with BRCA1 or BRCA2 mutations face a significantly higher lifetime risk of developing breast cancer, often at an earlier age than the general population. According to studies, BRCA1 mutation carriers have a 55-72% lifetime risk, while BRCA2 mutation carriers have a 45-69% risk of developing breast cancer. Additionally, the risk of ovarian cancer can be as high as 44% in BRCA1 carriers and 17% in BRCA2 carriers.
Who should consider BRCA testing?
While BRCA mutations are not common in the general population, certain individuals may be at a higher risk and should consider genetic testing. You may want to speak to a genetic counselor or physician about testing if you:
- Have a strong family history of breast or ovarian cancer (e.g., a mother, sister, or multiple relatives diagnosed at a young age)
- Have been diagnosed with breast cancer before age 50
- Have a known family history of BRCA mutations
- Have a personal history of ovarian, pancreatic, or aggressive prostate cancer
- Belong to certain ethnic groups, such as Ashkenazi Jewish descent, which have a higher prevalence of BRCA mutations
If you do not have these risk factors, routine genetic testing is generally not recommended. However, every woman should undergo regular breast health screenings, including mammograms and self-examinations.
Should you get tested for BRCA if you have implants?
If you have breast implants, the decision to undergo BRCA testing depends on your personal and family history. The presence of breast implants does not change your genetic risk of breast cancer, but it may affect the way your screenings are conducted.
Implants can sometimes make it more difficult to detect abnormalities on mammograms, which is why additional imaging techniques like MRI may be recommended for women with breast implants. If you test positive for a BRCA mutation, you may need to consider your options, including the possibility of prophylactic mastectomy (preventive removal of breast tissue).
Does the risk of breast cancer increase with implants?
Currently, there is no strong evidence linking silicone or saline implants to an increased risk of breast cancer. However, breast implants have been associated with a rare cancer called Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), which is not a type of breast cancer but a form of lymphoma that develops in the scar tissue around the implant.
BIA-ALCL is a rare but serious type of non-Hodgkin’s lymphoma that develops in the scar tissue (capsule) surrounding a breast implant. It is not a form of breast cancer but rather a cancer of the immune system that has been primarily linked to textured breast implants. BIA-ALCL can present with symptoms such as persistent swelling, pain, fluid buildup (seroma), or lumps near the implant, often appearing years after implantation.
If detected early, it is typically treatable with breast implant and capsule removal (en bloc capsulectomy) and, in some cases, additional therapies like chemotherapy. Removing breast implants is the most effective way to eliminate this risk entirely. As such, while breast implants don’t directly increase the risk of most breast cancers, they can increase the risk of BIA-ALCL.
Should I consider breast implant removal?
If you have BRCA gene mutations, it is worth considering breast implant removal to minimize the risk of BIA-ALCL and to improve breast cancer monitoring.
While breast implants do not directly increase the risk of common types of breast cancer, they can make it more challenging to detect abnormalities during routine screenings, potentially delaying diagnosis. Implant removal allows for clearer imaging on mammograms, ultrasounds, and MRIs, ensuring that any signs of cancer can be detected earlier and more accurately.
Additionally, removing implants eliminates the possibility of developing BIA-ALCL. For women with a BRCA mutation or an increased risk of breast cancer, opting for natural reconstruction after implant removal can be a proactive approach to prioritizing long-term health. Dr. Khan specializes in safe, implant-free reconstruction techniques to help women make the best decisions for their well-being.
What are your options if you test positive for BRCA?
If you test positive for a BRCA mutation, you have several options, depending on your risk tolerance and personal preferences:
- Increased monitoring: More frequent breast cancer screenings, including MRIs and mammograms, to catch any abnormalities early.
- Prophylactic mastectomy: Some women with BRCA mutations choose to have both breasts removed to reduce their cancer risk. Many opt for natural tissue reconstruction afterward.
- Risk-reducing medication: Some medications, such as selective estrogen receptor modulators (SERMs), may help lower the risk of breast cancer.
- Lifestyle modifications: Maintaining a healthy diet, exercising regularly, and limiting alcohol intake can help reduce overall cancer risk.
- Breast implant removal: Eliminating implants can reduce the risk of BIA-ALCL and improve the accuracy of breast cancer screenings, allowing for earlier detection.
If you are considering mastectomy due to a BRCA mutation, Dr. Khan can guide you through the process of natural breast reconstruction without implants, using advanced surgical techniques to achieve the best possible results. If you have questions about BRCA testing, breast implants, or your surgical options, schedule a consultation to receive transparent, honest guidance.
