Cherie Miller is only 26 and has never had cancer. And yet some time before her 28th birthday she plans to undergo a double mastectomy.
What the Santa Rosa woman does have is a genetic mutation that vastly increases the likelihood that she will get breast cancer at a young age.
Miller's mother was just a baby when her 28-year-old mother was diagnosed with the disease. As a tiny pre-schooler, Miller watched her mother suffer through sickness and treatments, only to die at the age of 31. Miller was just 5.
For Miller, the thought of losing her breasts, however difficult, is not as traumatic as the potential alternatives.
"I would never want to go through the experience of radiation and chemotherapy, because that was what was really difficult to watch with my mom and why I want to avoid that so much," Miller said. "I don't want to go through all the hell to try and fix it, and then to die anyway."
Miller tested positive for a breast-cancer (BRCA) gene mutation, which accounts for 5 to 10 percent of all breast cancers and one in seven ovarian cancers, according to the National Institutes of Health.
The BRCA1 and BRCA2 genes, when normal, help prevent uncontrolled cell growth. But when there is a mutation — both men and women can carry the gene and can pass it on — a woman faces not only a higher risk of breast cancer, but also a significantly higher risk for ovarian cancer as well as other types of cancer, depending on which gene mutation she has. Men with the mutation also have a higher risk of breast and other cancers.
The BRCA gene mutation is the most common cause of hereditary breast cancer and a significant cause in younger women. It is only one, however, of a number of risk factors that women should be aware of. Knowing what those factors are, experts say, can reduce a woman's chance of getting the disease or increase her chances of surviving it if she does, by catching the cancer in the early stages when it's most treatable.
"The most significant risk for breast cancer is being older and being female," said Paula Kelleher, a nurse practitioner with the Kaiser Santa Rosa Breast Care Center. "In fact, three-fourths of all cases are over the age of 50."
There is no absolute predictor or magic bullet to prevent a disease that kills 40,000 women a year. Even women with a BRCA gene mutation may never get cancer.
Yet, there are some lifestyle choices women can make to decrease their risk, like maintaining a healthy body weight, getting regular exercise, limiting alcohol consumption and eating a good diet rich in fruits and vegetables, poultry, fish and low-fat dairy products.
There are several other gene mutations that have been connected to certain cancers and can be tested for, said Dr. Amy Shaw, director of the Cancer Survivorship and Prevention Program for the Redwood Regional Medical Center in Santa Rosa.
Beyond that there are other risk factors women may not be able to control but would be wise to be aware of. It appears that the more menstrual periods a woman experiences in a lifetime, the more vulnerable she is to breast cancer. That means that early onset of menstruation, late onset of menopause and not having children may increase one's odds of developing breast cancer. Conversely, breast feeding, which can delay menstruation, may provide some protection.