MRI Test Improves Woman's Destiny
CancerWise - July 2007
By Renee Twombly
Adell Taylor Brown knew she was destined to the same fate as six of her siblings, and she was right.
They all developed breast cancer, and so did she. But unlike the five who died of the disease, Brown, 59, detected her cancer early with the help of advanced screening technology.
Magnetic resonance imaging (MRI) scans are important for women like Brown, who possess certain high-risk factors that predispose them to breast cancer.
Because MRI scans can identify potential tumors earlier than mammograms, the American Cancer Society now recommends annual MRI screenings, in addition to yearly mammograms, for women with certain risks.
Given Brown's family history, a rare situation with so many immediate family members diagnosed with the same disease, Brown enrolled herself in
M. D. Anderson's Clinical Cancer Genetics program. There she received alternating mammograms and magnetic resonance imaging (MRI) tests every six months.
In December 2006, an MRI scan detected a small tumor that was not found by a mammogram six months before.
"If I had not had the MRI, it would have been another six months or more before a mammogram could have picked up the tumor, and by then it might have spread," says Brown, a middle-school math teacher in Rosenberg, Texas.
"That MRI made a huge difference in my life. I am just so sad that it wasn't available for my four sisters and for my brother."
Breast cancer strikes majority of family
Brown is the youngest of seven girls and five boys. Her father developed prostate cancer at 56 and died two years later.
When she was 28, Brown's oldest sister developed breast cancer, and six months later, her next oldest sister was diagnosed with the disease. Both sisters were in their 40s, and they both had mastectomies. About a decade later in 1992, they died within eight months of each other after the disease recurred.
The third sister had benign breast tumors, and a year after her oldest sisters died, the fourth sister developed breast cancer in 1993 with a recurrence to the brain in 1996. She passed away in January of this year.
Another sister was diagnosed with the disease and is still in remission. Then Brown's twin sister, Maedell, was diagnosed with an aggressive form of breast cancer in 1995 with recurrence in the bones and lungs in 1997. She died in 2000 at age 52.
Remaining family members receive testing
"When my twin sister passed away, we all received genetic testing from The University of Texas Southwestern Medical Center at Dallas," Brown recalls. "The center sent nurses out to our family reunion to take blood samples, and the nurses even traveled to family who could not make it to the event."
They were looking for evidence of two susceptibility genes, mutations in BRCA1 and BRCA2, which have been linked to development of both breast and ovarian cancer.
Brown had a BRCA2 mutation. One of her nieces also had the BRCA mutation. "I was told that I had up to an 80% chance of developing breast cancer and a substantially increased risk of ovarian cancer," Brown says. "I knew it was a matter of time before I was diagnosed with cancer."
She is convinced this began with her father because her mother did not die from the disease. And her suspicion could be right, although her father had never been tested for the BRCA mutation. According to the National Cancer Institute, there is an approximately twofold increased risk of prostate cancer in BRCA2 mutation carriers.
Brown is diagnosed with the disease next
Cancer left the family alone for almost a year, and then one of her brothers developed breast cancer and subsequently died in 2004. Brown also has several nieces who have been diagnosed with the disease, one of whom passed away in 2002.
Feeling sure she would be next, Brown started seeing cancer prevention experts at M. D. Anderson, who monitored her regularly with mammograms and vaginal ultrasound. In 2005, she had a hysterectomy to help eliminate the chance of developing ovarian cancer, which is often more aggressive and even more stealthy than breast cancer.
That year, given her high-risk status, she began receiving MRI screening tests along with mammograms through the cancer center's Clinical Cancer Genetics program.
In late 2006, the cancer Brown feared finally showed up.
It was a small tumor (1.1 centimeter, or .4 inch). Two even smaller ones were discovered when Brown had a double mastectomy this March.
"The mammogram I had before March didn't show anything, and because I have lumpy breasts, I could not feel the tumor," she says.
That is when an MRI detected the cancer.
MRI will be recommended for children if at risk
Brown is now in the middle of chemotherapy treatment, which she says is going as well as she could expect. She experiences moderate side effects. "Only the first week after therapy is difficult," she says. And she adds that she doesn't worry any more, at least not about herself.
"I just take each day as it comes," Brown says. "I have seen so many of my relatives and friends go through this that I think if they can do it, so can I. As long as there are new drugs and techniques to fight this dreaded disease, there is always hope."
But she is concerned about her two sons, who are 18 and 24, and hopes they will be tested for the gene mutation. "I believe the children of a parent who has been diagnosed with breast cancer should strongly think about genetic testing. My husband and I have talked it over with our 24-year-old, and he has expressed a desire to be tested for gene mutations, so M. D. Anderson will be seeing him shortly."
And if the tests are positive, Brown says she will be there to recommend MRI screening. "It saved my life."
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