INTERACT

Breast Cancer Scenario

The average American woman has about a one-in-ten risk of contracting breast cancer in her lifetime. But for women who have a mutation on one of two specific genes (BRCA-1 or BRCA-2), that risk may be as high as 80 to 90 percent.

The BRCA-1 and BRCA-2 mutations account for about one-tenth of all breast cancer cases, and for possibly half of early onset cases (before age 45). Some mutations in these genes are also linked to an increased risk of ovarian cancer.

Any woman can have the BRCA-1 or -2 mutation, but the incidence of these mutations in the general population is very small. Among Ashkenazi (Eastern European) Jews, however, the incidence of the mutation is between 2 percent and 3 percent.

Sonya is of Ashkenazi descent. As her family gathers around her during these final days, they learn that the impact of Sonya's cancer is more than strictly emotional. A genetic test has revealed that Sonya carries a dominant mutation that predisposed her to getting breast cancer. Her children have a 50-percent chance of inheriting the mutation, and if they do inherit it, her daughters and granddaughters face a greatly increased chance of contracting breast cancer themselves.

Now her family members are faced with choices of their own.

Daughter Elizabeth, an unmarried, five-year breast cancer survivor

Daughter Judith, a married, healthy 41-year-old mother of two

Granddaughter Miriam, a teenager

Son David, engaged to be married