Brandi Preston | August 20, 2020
Thanksgiving Day is a time we all find ourselves gathered around the family table, sharing laughs, stories and sometimes—family health history. On Thanksgiving Day in 2000, my family health history changed in a way I will never forget.
I remember where I was (sitting straight across from my mom, to the left of my brother and to the right of my sister), but I don’t remember anything after my mom said, “I have breast cancer.” I remember her trying to console me, then telling her I hated her and to leave me alone. I remember her asking me if I wanted a drink of water and replying, “I don’t want to catch your cancer.”
She told me, “Honey, cancer is not contagious. You won’t catch it from me.” At the time, I knew so little about this disease. I didn’t know it eventually would take her job (as an Omaha police officer), her strength (as a marathon runner and athlete), her health, her confidence and, ultimately, her life.
Although I knew I couldn’t “catch” cancer, there was still the potential that Mom’s cancer risk would pass to me—the same way she shared her beautiful blue eyes with me—through our DNA.
My mom was initially diagnosed with estrogen-positive breast cancer at the age of 35. She was “cancer-free” for a short period of time before another diagnosis of triple negative breast cancer.
My mom was not offered genetic testing until the cancer was too advanced, when there were no surgery or treatment options that could change the course of her care. Metastatic breast cancer, driven by a BRCA1 mutation, was my mom’s death sentence.
Three days before she passed away, she gave me a binder full of her health records, including her genetic test results, and said, “Someday I hope this helps you, because I won’t be here to.” She made my siblings and I promise to take care of each other, to look after our grandparents and to seek genetic testing so we could be proactive with our health, because she was never given that option.
Five years later, on my 19th birthday, I was tested for the BRCA1 mutation my mother carried. That’s when I learned I inherited a gene that gives me an 87% lifetime risk of breast cancer, a 63% lifetime risk of ovarian cancer and elevated risk of pancreatic cancer and melanoma. Unlike my mother though, I knew about my risk prior to a cancer diagnosis. At the age of 22, I was able to have a nipple-sparing bilateral mastectomy and reconstruction.
With this choice, I lowered my cancer risk from 87% to less than 2%.
We so often talk about a cure to cancer, but I truly believe prevention has been my cure. I cannot think of any gift that’s greater than that.
An estimated 5-10% of all cancers are caused by an inherited mutation, like BRCA or Lynch syndrome, but so many people are unaware of their risk and of coverage for screening options. Although the guidelines are there for screening people at higher risk, we fail to identify these at-risk patients each and every day.
I beg clinicians to incorporate cancer risk assessments and hereditary cancer testing into their practices. I encourage patients to advocate for themselves, know their family health history, ask questions of their health care providers, and, if/when testing is offered, use this knowledge to take control of their health. This can save lives.
Finding out more about our cancer risk is not something we should fear—it’s something we should embrace. It’s information we can arm ourselves with to prevent a cancer diagnosis. That’s the gift my mom gave to me, and for that I’ll always be grateful.
Meet Brandi on September 9 at the virtual 2020 Advocacy Workshop: Genetics, Genomics and Biomarker Testing. In her keynote address, Brandi will tell her story and talk more about the importance of genetic testing. Registration for this event is free.