JACKSONVILLE, Fla. - Dr. Rebekah Richmond is healthy, happy and the mother of two boys. She also just had a life-altering surgery, a double mastectomy and hysterectomy.
At 39 years old, Richmond chose to remove the most feminine parts of herself after testing positive for the BRCA1 gene mutation.
"There's a fear on a day-to-day basis that you're a ticking time bomb," Richmond said.
Genetic Councilor Medlinda Fawbush said more women are asking about the BRCA test since Angelina Jolie went public with her preventative cancer surgeries. Fawbush said it's known as a genetic coin flip.
"Only 5 to 10 percent of breast cancer falls into the category of hereditary and you have to meet certain criteria to need the test," Fawbush said.
Insurance will cover the 2 to 4 thousand dollar price tag, but only if you have risk factors such as a family history of breast cancer, Ashkinazi Jewish heritage or if you developed breast cancer under the age of 45.
According to the Susan G. Komen Breast Foundation, out of 100 women without the mutation, eight will develop breast cancer by 70, and women with the mutation, between 45 and 65 will get breast cancer by age 70. However, testing negative for the BRCA1 mutation doesn't mean you're not at risk.
Fawbush said the majority of breast cancer, 75 to 80 percent, is what they call sporadic, and includes environmental factors and age. Another 10 to 15 percent of breast cancer patients have a family history.
According to the Susan G. Komen Foundation, 1 in every 400 people have the mutation, but for Richmond her risk was much higher.
"We're both Ashkenazi Jewish, 1 in 40 carry the gene," Richmond said.
Even with no history of female cancers in her family, Richmond, who is also an OB/GYN, made what she calls an easy choice.
"I need to be here, to be at the first prom, I need to scold the first girl who breaks my son's heart and so there was no doubt in my mind that I was going to remove the organs that would potentially be fatal to me," Richmond said.
Dr. Richmond's husband is a plastic surgeon and supported his wife's decision to have the preventative surgery.
"We're very good at treating preventative disease," said Dr. Erez Sternberg. "So now you're taking healthy women with healthy breasts and it's much easier to reconstruct then to take an unhealthy women who's going through chemo."
It's an experience the couple says, has made them better physicians. Both have taken what they've learned into their practices, talking to patients about family history and health screenings.
Richmond admits many women may choose not to have the preventative surgeries she did, but knowing all you can about your body, puts the power to choose in your hands.
"I want someone else to have the same opportunity to have their life saved with this test, which is what it did for me, it saved my life," Richmond said.
Richmond said the hardest part is knowing she may have passed on the BRCA mutation to her sons, which would increase their cancer risk.
- What to Do if Your Genetic Test Results Are Positive
- Inherited Gene Mutations
- BRCA1 and BRCA2: Cancer Risk and Genetic Testing