October 19, 2021 by Peter B. Laird
For Cancer Previvor, Surgery Means Not Having to Worry
By all accounts, young mother Leah Goldglantz is in optimal condition. A health blogger with certification as a holistic nutrition coach, she develops recipes with clean and healthy ingredients. She’s also a sports enthusiast who has always been physically active. But when it comes to cancer risk, there is one thing she can’t control: the genes she has inherited.
Ms. Goldglantz’s maternal grandmother had battled both breast and ovarian cancer, so at age 32, after the birth of her second daughter, Ms. Goldglantz underwent genetic testing. Her results came back positive for a BRCA1 mutation, substantially increasing her odds of developing breast and ovarian cancer. Sept. 29-Oct. 5 is National Hereditary Breast and Ovarian Cancer Week, marking the transition between National Ovarian Cancer Awareness Month and National Breast Cancer Awareness Month.
Known as a previvor, Ms. Goldglantz has a proven inherited mutation that is linked to cancer, but she has never been diagnosed with the disease. After counseling with genetics expert Louise Morrell, M.D., medical director of Lynn Cancer Institute at Boca Raton Regional Hospital, a part of Baptist Health South Florida, Ms. Goldglantz came to a decision. At the age of 34, she had a bilateral mastectomy.
“She spent so much time with me on our first visit,” Ms. Goldglantz said of Dr. Morrell. “I’ve never had a doctor in my life spend over an hour with me just talking, which was really incredible. And she armed me with all of the information I needed. She gave me all of the facts, all of the statistics, and really, really helped guide me in what I should do.” (See Ms. Goldglantz’s video story here).
Patients in the same situation as Ms. Goldglantz do have options, Dr. Morrell explained. Among them are lifestyle modifications, early and frequent screenings and monitoring, medications and surgery. “It can be very dramatic news when someone finds out they have a mutation that is linked to cancer,” Dr. Morell says. “It’s a very personal choice both as to whether to do the surgery and when to do the surgery.”
When she discussed options with Ms. Goldglantz, Dr. Morrell listened to the Boca Raton mother’s concerns about breastfeeding her infant. “She made me very calm,” Ms. Goldglantz recalls. “She told me, ‘Enjoy breastfeeding your baby as long as you want. And when you’re done, let’s talk about getting a mastectomy.’ ”
On September 30, 2020, breast surgeon Joseph Colletta, M.D., performed a bilateral mastectomy, and, at the same time, Ms. Goldglantz underwent a reconstructive procedure by David Bogue, M.D., a plastic and reconstructive surgeon. She was in the hospital one night and had a speedy recovery.
Genetic testing results are often key to a previvors decision-making process, Dr. Morrell says. While the test itself is as easy as a saliva or blood sample ― and the cost has come down substantially in recent years from thousands of dollars to between $250 and $450 ― it’s the counseling that goes along with the results that is vital.
“At the Morgan Pressel Center for Cancer Genetics at Lynn Cancer Institute, we offer a patient-centered approach that ensures the patient understands the lifelong implications of the testing,” Dr. Morrell says. “In addition to risk assessment, testing, and education and counseling, including talking about the need for any family members to be tested, we put the family tree into a database. If new genes get discovered, we can then reach out to any patients who might benefit from the new information.”
Dr. Morrell advises against using popular consumer DNA programs as a tool to make medical decisions. “They are interesting and fun, but they are limited to a very few number of mutations,” she says. In addition, the vast majority of cancers are not inherited.
Because she is BRCA-positive and her grandmother had ovarian cancer in addition to breast cancer, Ms. Goldglantz says she will consider removing her ovaries and other reproductive organs as she approaches age 40, when the risk for ovarian cancer jumps for BRCA-positive patients.
For now, she says, she is enjoying life with her husband, Josh, and daughters Emma, 5, and Jordyn, 3. “Hopefully I will be here for them for a long time,” Ms. Goldglantz says. “That’s what this surgery symbolizes for me. I was worried that my life could potentially be cut short. And when you have two young children, there’s nothing more terrible than that thought. I’m able to just breathe and live my life and not worry about breast cancer, which there’s nothing more amazing than that.”
Read more about Ms. Goldglantz and check out her healthy recipes at https://www.leahsplate.com/. Learn more about the genetics program at Lynn Cancer Institute at https://www.brrh.com/Services/Lynn-Cancer-Institute/Cancer-Genetics/Meet-Our-Team.aspx.