SHD Reun 409 - Shodair Children's Hospital

A cancer
risk assessment
includes:
• Obtaining complete family history and medical records.
• Assessing individual cancer risk.
• Discussion of additional options, including DNA testing,
cancer surveillance, lifestyle changes, and potential preventative therapies.
• Consideration of pros and cons of testing, including potential insurance and employment issues.
• Gene testing, if indicated and desired.
• Evaluation of test results and their implications, including impacts on other family members.
An assessment may be recommended for an individual with:
• A cancer occurring at a younger age than expected for that type of cancer.
• The development of more than one tumor in a single individual.
• Multiple family members with cancer.
• Rare cancers such as childhood cancer or male breast cancer.
For more information
contact Shodair's
Genetics Department
at 1-800-447-6614
or (406) 444-7530
Danyelle's
Story
Editor’s note:
Patient permission
was obtained to
share this story with
Reunion readers.
Special thanks to
Danyelle Dotson for
allowing us to do so.
Spring 2009
How do you decide if cancer risk counseling is right for you?
For people like Bozeman resident Danyelle Dotson, the choice was easy.
“I wanted to get a cancer risk assessment because both my mom and my grandmother had breast
cancer,” Danyelle explained. “My mom suggested it, because both she and my grandmother had
genetic testing done that showed they were both positive for the BRCA2 gene.”
A breast cancer (BRCA) gene test is a blood test to check for specific changes (mutations) in genes
that help control normal cell growth. Finding changes in these genes, called BRCA1 and BRCA2,
can help determine a person's chance of developing breast cancer and ovarian cancer.
Danyelle turned to Shodair's Genetics Department when she was ready to schedule counseling
and testing. In January 2006, Danyelle traveled to Helena to meet with genetic counselor
Katherine Berry to discuss her family history and get the breast cancer gene test done. The
following month, Danyelle saw Katherine again to receive her test results at one of Shodair's
monthly genetic outreach clinics in Bozeman.
“It was a little overwhelming,” Danyelle, 33, recalls. “I knew I had a 50% chance of having the
BRCA2 gene, but in the back of my mind I hoped it wouldn't happen to me.”
Katherine and Danyelle discussed options that were available to her once the positive diagnosis
was received. Since Danyelle's mother and grandmother both survived breast cancer, she
originally chose vigilant surveillance for any signs of breast cancer, with the possibility of
undergoing surgery when she got older.
Danyelle and Katherine stayed in touch over the next two years via follow-ups over the phone.
“Katherine was able to put me in touch with a couple women locally who were in the same
situation,” Danyelle recounted. “Visiting with them was helpful; it made me feel like I wasn't
the only one.”
Then, in December 2007, Danyelle got a mammogram done, followed by a biospy at the recommendation
of her healthcare provider. In February of this year, she had another mammogram, and
her physician suggested a biopsy on her other breast. “I decided it was time to take a proactive
approach to my healthcare and start considering my surgical options,” Danyelle said.
This spring, Danyelle chose to undergo bilateral prophylactic mastectomies, followed by
immediate implant reconstruction. The busy medical transcriptionist and mom of three young
boys says her decision was right for her, but acknowledged that options are varied and uniquely
personal. Danyelle emphasized, “Every woman's situation is different, and your decisions should
be based on what's right for you. Get as much information as possible, so you're able to make
a good and informed decision.”
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