BRCA-1 (breast cancer gene -1)

BRCA-2 (breast cancer gene 2)

What are the BRCA-1 and BRCA-2 Genes?

These are the genes inherited from the parents, one copy from either. The BRCA genes help repair damaged DNA. These are tumor suppressant genes that inhibit uncontrolled cell division and proliferation. The mutations in the BRCA genes initiate excessive cell proliferation in both males and females.

Risk Factors for BRCA Gene Mutations—

• Family history – If any of the close family members have breast or ovarian cancer, or any other cancer, like pancreatic cancer or prostate cancer, it increases the risk of BRCA gene mutation. A family member having breast cancer at an age of less than 50 years indicates a risk of BRCA gene mutation.
• Personal history of cancer – Cancer history of breast cancer, prostate or pancreatic cancer increases the risk of BRCA mutations. A person having multiple cancers causes mutations in the BRCA genes.
• Ethnicity / Ancestry – people of Ashkenazi Jewish descent are at higher risk for BRCA gene mutations. Compared to the general population, the risk of BRCA gene mutation increases 10 times in Ashkenazi Jews (Central and Eastern European ancestry) because their ancestors had certain mutations which carried on to the next generations.
• Recurrent breast cancer or cancer in both breasts – The cancer that occurs in both the breasts and that which returns indicates harmful mutations of the BRCA genes, which may pass into the next generation.

Types of Cancers Caused by BRCA-1 Gene Mutations

• Breast Cancer – The mutated BRCA-1 gene has an early onset of triple-negative breast cancer or cancer in both breasts. The cancer caused by a BRCA mutation has a chance of coming back and recur after 20 years or before.
• High-Grade Serous Ovarian Cancer – It is a common cancer that develops in the epithelial cells or the surface cells of the ovaries or fallopian tubes. It comprises 60-80 percent of ovarian cancers.

Other cancers less likely to be caused by the BRCA-1 mutation include –
Pancreatic cancer, prostate cancer, and skin cancer.

Types of Cancers Caused by BRCA-2 Gene Mutations

• Breast cancer – The BRCA-2 gene mutation alleviates the risk of breast cancer in both females and males. It is strongly linked to breast cancer in men in both breasts.
• Ovarian cancer – Both BRCA-1 /2 mutations elevate the risk of ovarian cancer. The risk caused by the BRCA-2 mutation is lower than that caused by the BRCA-1 mutation.
• Prostate cancer – Men with the BRCA-2 mutation have a high risk of getting aggressive prostate cancer that spreads rapidly to bones and lymph nodes. They usually have an early onset of prostate cancer before 60 year age of.
• Pancreatic cancer – BRCA-2 gene mutations increase the risk of highly aggressive and fast-spreading pancreatic cancer at a younger age.
• Melanoma (skin cancer) – The changes in the DNA or the BRCA-2 gene caused by UV radiation increase the risk of skin cancer, melanoma in the eye, and the skin.

How to Manage the Risk of the BRCA Gene Mutation?

Knowing the risk of BRCA gene mutations helps in taking early preventive steps for effective management.

• Enhanced Screening – People bearing the risk of BRCA mutations should strictly start regular breast cancer screening and other cancers, like pancreatic cancer or prostate cancer, at a younger age.
• Preventive Surgeries – The tissues that are likely to develop cancer are being removed, like the removal of both the breasts, ovaries, and fallopian tubes.
• Risk-reducing Medicines – Tamoxifen and raloxifene are often used as preventive treatment to reduce the risk of BRCA gene-mediated breast cancer. The pills used to avoid childbirth (oral contraceptives) also reduce the risk of ovarian cancer.
• Lifestyle Measures – An active lifestyle with optimum physical activity and controlling weight, alcohol, limiting UV exposure, and smoking reduces the risk of developing cancer.
• Targeted Therapies – The various chemotherapy drugs used in BRCA-related cancer include –
• Platinum Chemotherapy – Carbokast (Carboplatin), Cycokast (Cisplatin). PARP inhibitors – Niraparib, Talazoparib, and Olaparib (Olaparib) are highly effective in breast cancer, ovarian cancer, and prostate cancer.

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