By Andrea Brown, Special to The Herald
Some genes are a blessing. Some are a loaded gun.
Meghann Johnson was surprised when she found unrelenting cancer in her genealogy. And what she did next might surprise you.
At age 31, healthy and cancer-free, she had both of her breasts removed — plus her ovaries.
“I would do it again,” she said.
Her mother had undergone a mastectomy because of breast cancer, so Johnson knew what to expect when she had her own surgery last year.
But that’s where the similarities end: Genetic testing revealed that her cancer predisposition was not her mother’s cancer.
Johnson, it turned out, inherited the bad gene from her father, who died of cancer at age 45. His mother died early from breast cancer, as did an aunt.
Johnson didn’t consider a double mastectomy and hysterectomy paranoid; rather, it was proactive.
Joy Varady, genetic counselor at Providence Regional Medical Center, calls her a cancer “presurvivor.”
Though Johnson didn’t have cancer, she was at high risk based on “family pedigree,” Varady said.
The majority of inherited breast cancers in both men and women are caused by defective BRCA (BReast CAncer) 1 and 2 genes. If a woman carries mutations she also has a higher risk of ovarian cancer. Males have a slightly increased risk of pancreatic and prostate cancer.
“My risk factor was 87 percent for breast cancer and ovarian was 54 percent,” Johnson said.
“Now, it’s less than 5 percent.”
That, she said, was worth undergoing four major surgeries even with no sign of cancer.
“It was actually a relief to me,” Johnson said. “I felt like I could do something about it.”
She recalls when her mom was diagnosed with breast cancer in 2001, six years after her dad died.
“It was scary, because I had already lost one parent,” Johnson said. “I was faced with a lot of what-ifs.”
Still, she was unaware of her cancer risk until last year when her brother’s wife started researching her dad’s family tree for fun, and along the way unraveled the lineage of early onset cancer deaths.
That prompted Johnson to seek genetic testing. Her mom was subsequently tested and found to not carry the abnormal gene. Overall, most cases of breast cancer are not genetic.
Varady said some people at risk opt not to get the blood test, which is done by a simple blood draw. Those with the harmful gene have options other than preventive surgery.
“It’s a personal decision,” Varady said.
Johnson wasn’t taking any chances.
“Being married and having two kids (ages 6 and 11) put me in a position to make those decisions easier,” she said.
Still, it took juggling a busy schedule. She lives in Snohomish, takes dental hygienist classes in Everett and works as a dental assistant in Monroe. She keeps an athletic regimen of indoor soccer, exercise and family ski trips.
After the mastectomy, she had two surgeries to reconstruct her breasts and nipples.
“In my clothes, you would never know,” she said.
Yes, she got to choose her new bra size and, no, she didn’t go Dolly Parton.
“I chose a size proportionately physically,” she said. “I didn’t want them to get in my way of sports. I didn’t want to draw anymore attention than needed.
She does receive some, well, requests for showings.
“It’s a work of art,” she said. “And it’s somebody else’s. Modesty goes right out the window.”
Johnson said her son and daughter have a 50 percent chance of having the gene and passing it on to their kids. Her children can’t get tested until they turn 18, if they choose.
For now, she’s focusing on toting them around and taking them skiing.
“Who knows where we’ll be at that time toward a cure,” she said.
What are the odds?
• Out of 100 average women, about 12 will get breast cancer sometime during their lives.
• Out of 100 women who have one relative with breast cancer, about 24 will get breast cancer.
• Out of 100 women who have two relatives with breast cancer, about 36 will get breast cancer.
• Out of 100 women who have inherited a breast cancer gene, between 35 and 84 will get breast cancer. Women with the inherited gene also have an increased risk of developing ovarian, colon, pancreatic and thyroid cancers as well as melanoma.
Source: Providence Regional Cancer Partnership