# BRCA Gene Defects and Breast Cancer: Doing the Math

“You cannot come home because the math is hard.”

This is what my Mom said to me in the first grade when I wanted to leave school early one day. Math was giving me a bellyache. Today, a different kind of number problem troubles my little gray cells. Statistics. To be specific, breast cancer statistics.

The American Cancer Society’s 2012 estimates for the number of predicted cases of breast cancer in the United States for the year that just ended are as follows:

• About 226,870 new cases of invasive breast cancer will be diagnosed in women.
• About 63,300 new cases of carcinoma in situ (CIS) will be diagnosed (CIS is non-invasive and is the earliest form of breast cancer).
• About 39,510 women will die from breast cancer

Hereditary breast cancer represents only 5% to 10% of new cancers diagnosed each year. When I get out my calculator (yes, I have to) and do the math this means 290,170 American women will have either been given a diagnosis of DCIS or invasive cancer and up to 29,170 of them will have that cancer as the result of faulty bits in their DNA. There are many genetic mutations that can elevate breast cancer risk, but the most common ones are the BRCA1 and BRCA2 mutations.

These are just the numbers for the ladies, mind you. Don’t forget men get breast cancer too. And do not even get me started on the ovarian cancer cases caused by BRCA defects. Or other cancers that occur at higher rates in BRCA-positive folks. The math will overwhelm my pea brain.

I have been thinking about those 29,170 women who are in some stage of grappling with a new diagnosis of hereditary breast cancer in the past year. The thing that bugs me is that only a portion of them know their cancer is caused by a gene defect. Thousands of women will make important decisions about treatment and follow-up without the knowledge needed to make informed choices.

Why?

The BRCA (BReast CAncer) genes we call BRCA1 and BRCA2 were discovered fewer than twenty years ago. Testing for the full sequence of possible defects is expensive, limiting access to the test for some. There are other barriers that include lack of education and information on the part of patients, physicians and insurance companies.

I began writing about my experiences as a BRCA1 breast cancer survivor in 2012 as I went through numerous surgeries to reduce my risk for more cancer. Now that I am in the so-called “all done club,” at least as far as surgeries go, I plan to spend some time in 2013 tackling the larger issues.

Writing about my experiences has been good for my personal recovery from a year filled with trauma. It would be even more meaningful if this blog could help others. Visitors from more than 110 countries visited this site in 2012. I hope to engage, inform and entertain (I like to laugh) a wider audience in 2013.

Thank you to everyone who stopped by last year. Welcome to all those who I have yet to meet, like the 29,170 American women diagnosed in 2012 with breast cancer who may or may not know that they are part of an important minority: BRCA breast cancer survivors. Welcome also to those who are at risk for cancer, which means pretty much everyone on the face of this beautiful blue-green ball hurtling through space that we call Earth.