Fact-based journalism that sparks the Canadian conversation

Articles Business Environment Health Politics Arts & Culture Society

Special Series Hope You’re Well For the Love of the Game Living Rooms In Other Worlds: A Space Exploration Terra Cognita More special series >

For the Love of the Game

In Other Worlds: A Space Exploration

More special series >

Events The Walrus Talks The Walrus Video Room The Walrus Leadership Roundtables The Walrus Leadership Forums Article Club

The Walrus Video Room

The Walrus Leadership Roundtables

The Walrus Leadership Forums

Subscribe Renew your subscription Change your address Magazine Issues Newsletters Podcasts

Renew your subscription

The Walrus Lab Hire The Walrus Lab Amazon First Novel Award

Amazon First Novel Award

No One Told Me I Was at High Risk for Breast Cancer

It took years to learn just how vulnerable I was

In 2013, one of the most famous women in the world revealed that she was having a double mastectomy, despite not having cancer. In a New York Times op-ed, Angelina Jolie wrote that she had tested positive for a genetic mutation called BRCA1 that resulted, for her, in an 87 percent lifetime risk of the disease. Her announcement led to heightened breast cancer awareness and a stark increase in people seeking genetic testing, but I wasn’t one of them. The Canadian Task Force on Preventive Health Care (CTFPH) recommended that women begin having screening mammograms at age fifty, and I was twenty-eight. Surely, I told myself, it would be decades before I needed to worry.

If I’d had more information, I’d have known it wasn’t too soon at all. I have several chronic illnesses that land me on a doctor’s exam table more often than most and frequently fill out countless medical history forms, and still not a single medical professional discussed with me how my family history elevated my own odds or that I ought to start screening ten years before I reached the age when my mother was diagnosed. My mom had breast cancer at forty-one (and thankfully survived); my dad’s aggressive prostate cancer before age fifty-five is also linked to increased breast cancer risk. To put it plainly, I didn’t know what I didn’t know about my individual risk.

Turns out, I’m not alone. Many Canadian women are unaware not only of their own breast cancer risk factors but how that risk is calculated. The Jolie Effect increased genetic testing rates, but those without known genetic abnormalities might be left with a false sense of security. Early intervention is key to breast cancer survival; without the right information and tools, too many women lack the knowledge they need to advocate for their breast health.

Of the 32,400 Canadian women diagnosed each year, 75 percent of them have no risk factors at all other than biological sex. Being a woman, says Rachel Brem, professor of radiology and former director of the Breast Imaging and Intervention Center at George Washington University, is, to date, the best-known risk for the disease. Breast cancer does affect men but is far less prevalent—about 300 cases a year in Canada—since it is an estrogen and progesterone-fuelled disease. (The term “women” is used for here due to an unfortunate absence of medical research for non-binary and transgender people.)

Most people are aware that a family history of breast cancer—in mothers, aunts, sisters—increases one’s risk for breast cancer. According to Breast Cancer Canada, 26 percent of Canadian women say they aren’t worried about getting the disease since they don’t have a family history of it. Currently, thirteen genetic mutations have been identified as increasing odds of diagnosis, including the two types of BRCA, but these mutations only account for 5 to 10 percent of diagnosed cases. Rona Cheifetz, medical lead for the High Risk Clinic at BC Hereditary Cancer Program, estimates another 10 to 15 percent of cases are........

© The Walrus