Celaya, Guanajuato.- Tests to detect mutations in the BRCA1 and BRCA2 genes, which cause breast and ovarian cancer, are carried out in Celaya, in addition to preventive surgeries to reduce the percentage of risk of having this disease.
Paulina Calderillo, Geneticist who is at the Maternal Hospital of Celaya, explained that knowing these genes and if they have any mutation, can help to have a preventive surgery, which could reduce the percentage of having cancer, as did the actress Angelina Jolie.
To understand what we are doing, we must first explain how the genetics part enters cancer, cancer in 70 percent of cases is by chance ”, explained the medical specialist.
“In 20 percent of the cases, it is considered if there may be a predisposition, or a genetic load that is suspected that there are two or more relatives with cancer, but genetics is not enough to have cancer, it requires the environment, yes there is A more increased risk for those who have this history with family and environmental exposures, there is an increased risk compared to the first group of 70 percent, and the third group that is 10. Which is purely genetic, means that the patient is born with an alteration that puts them at high risk of cancer, so one in 10 women, speaking of breast cancer, has a genetic mutation, they are born with it, nothing happens, but these cancer predisposition syndromes affect people older than age, this is talking about breast cancer, because there are some that involve minors.
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He explained that the BRCA1 and BRCA2 genes are both related to breast cancer, ovarian cancer, skin cancer, pancreatic cancer, where having an alteration increases the risk of the disease.
BRCA1 gives a risk of breast cancer from 80 to 90 percent, in the other breast from 10 to 30, ovarian cancer from 50 to 60 percent, skin and pancreatic cancer from 2 to 5 percent and prostate from 20 to 30 percent, male breast from 7 to 10 percent “
“So these people can have 1 to 2, the most I have seen is three cancers, and the cause is having this alteration, they are independent cancers, it does not mean that they are spreading cancer, with new, independent cancers and It is very important to identify these families (genes), because because they are at high risk of continuing to cause more cancer, they have a genetic character and it is something that reaches the offspring ”, he said.
Certain criteria must be met
She said that she sees patients referred from oncology, and gives a diagnosis to see if they are candidates or not for the studies, which must meet certain criteria, as it is not for everyone.
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Some criteria to suspect that it is genetic is evaluated for breast cancer before 45 years of age, even if there is no family history, breast cancer in two or more relatives in which at least one is under 50 years of age. age, male breast cancer, high-grade papillary serous distinct ovarian cancer at any age, triple negative breast cancer before age 60, female with two cancers in this group, history-associated prostate cancer relatives. Although he stressed that the necessary antecedents are not necessary to generate a mutation in these genes.
Two ways of having genetic cancer, that I inherited it, with a family history, a mother with breast cancer, and the other is that the patient is a new case, that by chance, the genetic alteration was made, and his parents did not they have the antecedents, they are not necessary to think about these diagnoses ”, he explained.
He said that these free analyzes are done through AstraZeneca, who gives the support for free at the national level, but who asks for two requirements to be eligible, is to have a breast cancer with a triple negative tumor and a high-grade capillary triple ovarian cancer.
“It is an important help, we give them the papers, they speak, take samples and give me the results, and I deliver them in a month and a half. In Negatives we rule out that they have an alteration, and the ideal would be to be a panel to have everyone else under observation.
Positive patients, preventive surgery is recommended
“When patients are positive, if we find a mutation in these two genes, these patients are candidates for preventive surgeries, which are, removing both breasts, I see patients who no longer have one breast, if they have had breast cancer , are candidates to remove the other breast and remove the fallopian tubes and ovaries, due to a high risk of cancer, the uterus does not have a greater risk ”, he explained.
The geneticist advises the patients, talks to them about the advantages and risks of surgery, which have already been done at the Maternity Hospital.
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“If the patient does not want to have an operation, she does not have an operation, risk and percentage are explained to them, and we tell her that everything goes to zero if she has an operation, but if the patient does not want to, it is not done, what is done is order mammography and transvaginal ultrasound to see once a year that the ovaries have nothing,
He explained that to do this type of surgery there are specific ages, for BRCA 1 it is 35 to 40 years old, and for BRCA 2 it is for ages 40 to 45 years because they are of lower risk.
Case that hits famous
He explained that one of the most famous cases of what is done in case of having a genetic alteration, of these genes, was Angelina Jolie, who when testing positive for these mutations, decided to do preventive surgery to avoid cancer.
“It seems that it is isolated, novel or rare, in reality it is not, it is not so rare, the actress who made us fashionable, to geneticists worldwide was Angelina Jolie, the way it happened is that her mother and grandmother had breast cancer, and someone thought that it could be genetic and the mother was tested, it is a blood test, they do it and they find a genetic mutation, they monitor her and explain that it exists the risk of inheriting it to their children, they explain it to the children and there she is (Angelina), she has not had and they are candidates for the study and she tests positive, the risk percentages are explained to her, and that she is a candidate for the surgeries, she decides to remove her breasts, ovaries and tubes to bring the percentage to zero, it is a much lower risk than any Mexican woman, because she does not have a breast, she does not have ovaries or tubes, she does this and until today she has not had cancer, it faces pancreatic and skin cancer, but it is a percentage heh it’s very low ”.
She is an example that this follow-up has been carried out, we have many patients in the maternal that have undergone this treatment ”, explained Calderillo Cabrera.
He explained that so far it is impossible to measure whether this disease has decreased, but that progress was made on an important issue, he said it is safe.
In Guanajuato, the Maternity Hospital is the only hospital that carries out this type of action with the support of AstraZeneca, and they started in 2019.
“It is very important, because before, when we did not do the study, they identified themselves but there was no way to help them, if we recommended it but nobody did it, it is a lot of money for the population, at the moment that it is free, the cases increase, it is a turnaround Overall, genetic studies are essential, because without them there is nothing to check, without finding the alteration, surgeries cannot be authorized, it is important, complex, a great impact for the patient, either due to risk reduction, but negative impact for removing an organ, healthy, but in reality they are time bombs, we show percentages, they may not explode, but everyone decides if they take the risk, and the other is that as they are in DNA it is an alteration that can be inherited to the offspring, it is a 50 percent risk of giving it to children, being men or women, in families, it is very common to see women affected, because the percentages are high for breast cancer, ovarian cancer, than prostate cancer or cancer breast and n the male ”, he explained.
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