An improvised life

In July I met with a genetic counselor; it was a hoop I had to jump through in order to get genetic testing. I figured I had learned what I needed to know from the pamphlet, “Your Jewish Genes: Hereditary Breast Cancer and Ovarian Cancer,” [i] which I found in my oncologist’s waiting area .     But no! Bob Resta was a fast-talking, information-dense fount of facts [ii] . My attorney friend Layla and my physician father happened to be with me, and we were all fascinated, so I thought I’d share some of what we learned as I decimated Mr. Resta's bowl of Dove chocolate and madly scribbled in my notebook. [iii] American women as a whole have a 12 percent lifetime risk of breast cancer. Ninety percent of breast cancer cases do not have an obvious genetic component. There are six genes known to cause breast cancer, at least four of which he said I clearly did not have. Some 30 percent of women who have a breast cancer gene don’t have a family history of breast cancer.

I don’t spend a lot of time wondering how I got breast cancer. I basically believe we encounter a lot of non-point-source carcinogens throughout our lives, and cancer’s genesis in a person largely remains a medical mystery. We know that certain factors are correlated with an increased risk of breast cancer, including: -sedentary lifestyle -obesity -smoking -moderate alcohol consumption (3 drinks/week or more) -early-onset menses -family history/breast cancer gene -diet high in animal fat -not bearing children or bearing first child after age 30 -not breastfeeding -advanced age I don’t have a single one of these risk factors, and two years ago a life insurance company examined me inside and out and deemed me fit for the ultra-healthy rock-bottom rate (ha, fooled them!). But that doesn’t mean I couldn’t or shouldn’t have gotten cancer, just that it was statistically less likely. Overall, a woman’s lifetime risk of developing breast cancer is about 12 percent