Courageously facing a family history of breast cancer

When Fay Gordon learned she had breast cancer at age 35, she was scared but not surprised.

Cancer runs in her family. “My maternal grandmother passed away from breast cancer when she was just 44,” said Gordon. “The knowledge of her passing loomed large in my life growing up.”

Several other family members had received cancer diagnoses over the years, as well. But it wasn’t just her family history of cancer that readied her for the news.

Gordon’s ob-gyn had referred her to Kaiser Permanente’s hereditary cancer program, which educates patients about their genetic risks and options for risk reduction and enhanced screening for early detection.

The education and support she received had prepared her for the diagnosis. Now she and her care team were ready to address it.

The power of hereditary cancer programs

As part of Kaiser Permanente’s hereditary cancer program, patients receive personalized cancer-screening schedules and information about risk-reducing medical and surgical options. They’re also connected to a team of specialists, which may include a genetic counselor, a breast surgeon, a gynecologist, and a plastic surgeon, who help coordinate all aspects of their clinical care.

“It requires a unique health care system to support multidisciplinary clinics like these,” explained Bethan Powell, MD, gynecologic oncologist, who helped launch one of the first hereditary cancer centers at Kaiser Permanente in San Francisco.

“It doesn’t happen in most settings,” Dr. Powell continued, “but with our collaborative culture and support from our leaders, we’re able to work together as a team consulting on the same cases and focusing on providing patient-centered care.”

A personalized plan

Gordon’s genetic test revealed that she had a CHEK2 gene mutation, linked to a higher risk of both breast and colon cancer.

She met with Veronica Shim, MD, hereditary cancer lead at Kaiser Permanente East Bay in Northern California, and her care team designed a personalized early-detection plan. This included breast cancer screenings every 6 months with alternating mammograms and MRIs.

For people with a family history of cancer, fear about being diagnosed is quite common. That’s why the program also offers patients peer support from volunteers who have had similar experiences and professional mental health care from a therapist or social worker.

“Even though it was scary, I appreciated that I would be under regular monitoring,” Gordon explained. “Knowing that there was a plan helped me get a sense of control. And that’s ultimately why we were able to catch the breast cancer so early.”

Time to make a difficult choice

After Gordon’s stage 1 breast cancer diagnosis, she consulted with Dr. Shim, and they decided to surgically remove all of her breast tissue. This would remove the cancer and help prevent a recurrence.

“Dr. Shim understood my fears,” said Gordon. “She calmed me down and gave me and my husband, David, the facts and details we needed. I trusted her so much and knew she was going to get us through it. I will always be so grateful to her for that.”

A week after her surgery, Gordon received word that the procedure had successfully removed all of her cancer. No follow-up chemotherapy would be necessary, and her risk of recurrence was less than 2%. She received reconstructive surgery 6 months later.

And the year after her surgery, Gordon gave birth to a healthy baby boy named Leonel.