Courageously facing hereditary 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 mom's mom passed away from breast cancer when she was 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 only 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.

The power of hereditary cancer programs

Patients who take part in the hereditary cancer program learn about their genetic risk for certain kinds of cancer. They often start getting screened to catch cancer early. And they learn about various medical and surgical options to reduce their risk of cancer.

They’re also connected to a team of specialists who help coordinate all aspects of their care. These teams can include a genetic counselor, a breast surgeon, a gynecologist, and a plastic surgeon, as well as a therapist or social worker who can provide mental health care.

“It takes a unique health care system to support multidisciplinary clinics like these,” explained Bethan Powell, MD, gynecologic oncologist. Powell 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 consult together as a team.”

A personalized plan

Gordon’s genetic test revealed that she had a CHEK2 gene mutation. This meant she had 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. Dr. Shim and the rest of Gordon’s care team designed a personalized early detection plan. This included breast cancer screenings every 6 months with alternating mammograms and MRIs.

“Even though it was scary, I appreciated the regular monitoring,” Gordon explained. “Knowing we had a plan helped me get a sense of control. And regular screenings were the reason we caught the breast cancer so early.”

Later, when Gordon learned she had stage 1 breast cancer, she felt prepared because of the education and support she had received. She and her care team were ready to address it.

Time to make a difficult decision

After her diagnosis, she consulted with Dr. Shim. They decided to surgically remove all her breast tissue. This would completely 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 it had been a success. Her cancer was gone, and no follow-up chemotherapy would be necessary. Her risk of recurrence was less than 2%.

She received breast reconstruction surgery 6 months later. And the year after her surgery, Gordon gave birth to a healthy baby boy named Leonel.