Mary Ahn, M.D., F.A.C.S.
Fellowship Trained in Breast
Diseases |
Genetic Testing for Breast Cancer
by Mary Ahn, MD, FACS
When a woman or a man is diagnosed with breast cancer, many questions
are raised, including what do I do for my own health and what are
the risks for my daughter or sibling?
Traditionally, surgical intervention soon follows a diagnosis;
however, with more and more young people being diagnosed with breast
cancer, one has to consider surgical options as it pertains to
the current diagnosis as well as any possible risk reduction strategies
for recurrences or a second malignancy. With this in mind, some
men and women will need a comprehensive discussion of family genetics
prior to undergoing surgical intervention. We know more than we
did a decade ago, but not enough about the genetic component of
breast cancer. We do know that approximately 10% of breast cancers
diagnosed has an identifiable genetic abnormality. But, when a
man or a woman is identified as a carrier of BRCA1/2 mutation,
their risk of developing breast cancer and other cancers are dramatically
increased as compared to those without the mutation. When risks
are significantly increased, there are some preventive options
as well as modification of surveillance to accommodate the increased
risk.
American
Society of Breast Surgeons, American
Cancer Society, and National
Cancer Institute are some institutions that provide information
on recommendations for genetic testing as well as recommendations
for surveillance in high risk women.
One must consider who is at an increased risk of having a genetic
mutation. Some of the factors include own diagnosis of breast cancer
at a very young age, breast cancer in both breasts, or having both
breast and ovarian cancers; a family member who developed breast
cancer before the age of 50; having more than two immediate family
members with breast cancer - parents, siblings, or children; male
relative with breast cancer; more than one relative with ovarian
cancer; multiple generations of breast cancers; or a relative with
a known mutation. This is not a complete list. If any of these
factors exist or there are concerns about possible genetic mutation,
one should have a consultation with a genetic counselor to determine
if the rick of mutation is high enough to warrant actual testing.
The test itself is a blood test. What one does with the subsequent
result, whether positive or negative, that is more important than
the actual result. No mutation in the genes that we test does not
mean that you are not at an increased risk. There are unknown mutations
that might affect you. This is why it is so important to have a
discussion with a genetic counselor.
If a woman who does not have a diagnosis is found to be have a
mutation of one of the known breast cancer genes, one can consider
added surveillance with MRI in addition to the standard mammograms
and ultrasounds. One also needs to consider risk reduction options
which include tamoxifen and prophylactic mastectomies and oopherectomies.
One should be able to have a candid discussion with a breast surgeon
regarding these options.
If a woman with a recent diagnosis of breast cancer is found to
be a carrier of a mutation, that information can be used to determine
the type of definitive surgery she may consider as well as planning
post treatment care. This requires a multidisciplinary approach.
Many breast centers offer such options to women researching information
regarding their treatments. Breast surgeons work with medical oncologists,
radiation oncologists, genetic counselors, plastic surgeon, gynecologists,
nutritionist, social workers, and many others every day to help
guide women, and men, with treatment decisions. Most often this
is offered in separate series of sessions and consultations. Occasionally,
it is helpful for all of us to get together in one clinic to offer
a single, yet lengthy, session with the patient and family to provide
an opportunity to explore options together.
In summary, genetic mutation may affect how you decide with respect
to surgery and surveillance. A comprehensive review and discussion
is necessary. Genetic testing should not delay appropriate treatment.
When we all work together, we can come up with an individualized
plan of treatment that satisfies oncologic safety and timely treatment.
NOTE: This is a complicated issue; please discuss this with your
physician to gain a full understanding of your options.
Mid Illini Surgical Associates to Welcome Dr. Mary Ahn, Fellowship Trained in Breast Diseases
(Peoria, IL) Mary Ahn, M.D., F.A.C.S., a breast surgeon at Mercy Hospital in Maine, will relocate to the Midwest when she joins Mid Illini Surgical Associates (MISA) in May. Dr. Ahn has specialized in breast care for the past five years and is looking to move back near family. She believes the position at MISA is the right fit in terms of community and practice.
“I am eager to work with the surgeons at MISA and to provide efficient and seamless care for women with breast concerns,” Dr. Ahn said. “I will work closely with both medical and radiation oncologists, as well as local radiologists, to offer state-of-the-art care for cancer patients.”
Dr. Ahn completed medical school at Loyola University Stritch School of Medicine in 1995, then continued her training by completing her general surgery residency there. Following her residency, she completed a one-year Clinical Fellowship in Breast Diseases at the Cleveland Clinic Foundation Breast Center in Cleveland, Ohio. Dr. Ahn then served as a private practitioner with Breast Care Specialists of Maine.
“My goal is to provide comprehensive breast care – both benign and malignant – for patients in the community,” Dr. Ahn continued. “I will incorporate ultrasound-guided and stereotactic biopsies with state-of-the-art treatments, such as sentinel lymph node procedures and the placement of MammoSite® balloons.”
Board certified by the American Board of Surgery since 2001, Dr. Ahn has also been Associate Director of the Breast Health and Lymphedema Treatment Center in Maine. In addition, she has been the Cancer Liaison Physician for the American College of Surgeons Commission on Cancer and played a major role in Mercy Hospital’s becoming an approved Community Hospital Cancer Program. Dr. Ahn also mentors fourth-year medical students from the University of New England College of Osteopathic Medicine.
MISA is an experienced team of physicians, nurses and support staff who provide patients with comprehensive surgical care. The surgeons are skilled in the fields of general and specialized surgery, and are all Clinical Assistant Professors at the University of Illinois - College of Medicine in Peoria. They have surgical privileges at all four, major Peoria area hospitals.
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