Miss America Contestant Plans Double Mastectomy

Miss America contestant Allyn Rose plans to undergo a double mastectomy now that her participation in the 2013 Miss America competition is over. The 24-year-old says her mother battled breast cancer as a 27-year-old, and then again at 47. Her mother eventually died from breast cancer, as did her grandmother and aunt. Rose’s story highlights the challenge that women face in considering hereditary cancer risk.

Increasingly, women at high risk for breast cancer are choosing prophylactic mastectomy to greatly reduce their chance of getting breast cancer. While prophylactic mastectomy stories often make the front page, many women at increased risk for breast cancer choose other methods of managing their risk like enhanced breast cancer screening or risk-reducing medications. Jessica Long, CGC, a genetic counselor at Penn’s Basser Research Center for BRCA explains that “this is generally a very personal decision for each woman, even within the same family.”

Cancer Genetic Counseling at Penn

Cancer genetic counseling is an extremely important step in defining one’s cancer risk and considering interventions to address it. Genetic counseling with genetic counselors can help people who are concerned about their family history of cancer by

• Determining if genetic testing is appropriate for a family
• Interpreting genetic test results, since mutations in different cancer genes confer different risks
• Estimating cancer risks based on family history if no gene mutations can be identified

If a gene mutation is identified in a family, then family members can undergo genetic testing for that mutation to learn if they have inherited the increased cancer risk or not. For example, a mother with a BRCA1 mutation has a 50% chance of passing it on to each child. Despite the family history, individuals who do not inherit the mutation are typically at average risk for cancer.

Genetic counselors can also provide information on cancer risk by decade of life, information that can help women decide not just if but when to consider prophylactic surgery or other measures to manage cancer risk. For example, women with mutations in BRCA1 or BRCA2 have up to a 70 to 80% lifetime risk of breast cancer, but the risk for a BRCA carrier in her 20s to develop breast cancer by age 30 is about 1 to 2%.

Penn Medicine’s Cancer Risk Evaluation Program provides consultation with certified genetic counselors and medical oncologists. The Basser Research Center for BRCA within Penn’s Abramson Cancer Center was founded in May of 2012 to promote research on the BRCA1 and BRCA2 genes harmful forms of which cause hereditary breast and ovarian cancer syndrome.

Learn more about BRCA and hereditary cancer risk at Penn.