Beating breast cancer – before it strikes

Three percent.

That’s the number 25-year-old Christine Funke focuses on about her decision to have her healthy breasts removed earlier this year to reduce her risk for breast cancer.

By having a prophylactic double mastectomy – the medical term for elective surgery to remove both healthy breasts – Funke, one of the rare people who has what’s called the breast cancer gene, went from having an 87 percent chance of developing breast cancer to a 3 percent chance.

Three percent.

For Funke, that number more than made up for dealing with drainage tubes while healing after the surgery in May, putting up with rock-hard expanders in her chest wall to make room for her new implants next month, losing sensation in her breasts and wondering how to approach intimacy issues with a future boyfriend.

Having the elective surgery was a drastic step but one that was about three years in the making for Funke.

During that time, actress Angelina Jolie made news with her decision to have a similar surgery, Funke’s father discovered he was a carrier for the gene mutation, Funke’s mom underwent chemotherapy for another type of cancer, and Funke discovered she had the breast cancer gene. After the discovery, she spent a lot of time researching and talking to doctors, other family members who have cancer and friends and other women – young and old – who, like her, know they have the breast cancer gene.

Those three years – and the anxiety of having found what turned out to be a benign cyst – gave Funke time to conclude that she would strike the first blow at the threat of cancer before a cancer diagnosis could knock her down. A meme on her blog says it this way: “I didn’t fight like a girl. I fought dirty and cheated. I am a previvor.”

“Previvor” has become the buzzword for people who have a predisposition for cancer but who haven’t been diagnosed with the disease.

Breast cancer gene

While there are other gene mutations that can cause breast cancer, the most recognized is that of the BRCA1 and 2 genes. Everyone has these genes, which provide instructions to cells on how to make proteins to repair DNA.

About 1 in 400 to 800 people will test positive for the BRCA1/2 mutation, making it a relatively rare hereditary condition, according to the National Cancer Institute.

Men can be carriers of the mutation, and Funke’s dad, Dan Funke, found out he was a carrier in 2013. His family has a history of cancer – his mother died of liver cancer, his father of colon cancer, one sister was diagnosed young with breast cancer and another still fights ovarian cancer. Women who have the BRCA mutation also are at much higher risk for ovarian cancer.

In December 2013, the U.S. Preventive Services Task Force – a panel of national health experts who evaluates the latest studies and research – recommended that women with a family history of breast, ovarian, Fallopian tube and peritoneal cancer be evaluated to see whether they have the BRCA1/2 mutation.

Christine Funke’s older sister Debra has tested negative for the mutation; her younger sister Jessica has not undergone testing. Christine Funke found out she tested positive for the BRCA1 mutation in April 2014.

She didn’t undergo the testing because of the new government guidelines, however. She did it because of seeing her mother undergo a cancer journey against acute myeloid leukemia and then discovering a lump that turned out to be benign in her breast.

“The sonogram and biopsy (were) tough to go through and it scared me enough that I had to know if I carried the gene,” Funke wrote in a blog about her experience. It was April Fool’s Day 2014 when she met with a genetic counselor to have her blood drawn.

Making a plan

After getting the positive results, Funke immersed herself into knowing what being BRCA1 positive meant. She talked to a genetics counselor, breast care specialists and other medical professionals. Her options were what’s called surveillance – a rigorous, regular testing schedule of breast MRIs and mammograms – or surgery.

Her options brought up some other numbers, too – the financial costs. After earning a degree in education at Emporia State University, Funke had just started teaching kindergarten at Derby Park Hill Elementary School in 2015. Testing could cost hundreds of dollars every year toward her insurance deductible, and it wouldn’t reduce her risk.

Three percent.

Dropping her risk from 87 percent to 3 percent was the bottom line. Giving up her breasts – and making a plan for a future hysterectomy to lower her risk for ovarian cancer – was the best option, Funke decided.

“Vanity didn’t bother me. The possibility of a cancer diagnosis did,” Funke said.

The mastectomy option also meant making plans for reconstruction. She has opted for implants at this time and will pursue a longer-lasting reconstruction later. In that advanced procedure, the patient’s own skin and fat from the abdominal area are used to create breasts, resulting in a tummy tuck as well. When her implants need to be replaced in 10 years, Funke said, she hopes to have children by that time and then pursue the living tissue reconstruction. (A pregnancy would ruin the tummy tuck and affect the natural tissue breasts, she was told.)

Wanting to enjoy kids – whether it’s the kids she teaches or the ones she plans to have – and not have time cut short with them by cancer is another reason Funke made the decision to fight back against her odds.

Even her mother, who had expressed some reservations about such a drastic step, had to agree that the elective surgery was the right step to ease her daughter’s concern about cancer.

“The more I read and the more Christine shared what she had found about BRCA, I realized she was eliminating a major risk,” said Becky Funke, who has recovered from her cancer.

It came down to 3 percent.

This story was originally published September 19, 2016 at 6:48 AM with the headline "Beating breast cancer – before it strikes."