Barri Babow was not surprised to learn she had cancer. Describing her reaction to her 2010 diagnosis with triple-negative breast cancer, the Sacramento, California, tech industry program manager says, “I wasn’t upset; there were no tears, no outrage.” Having watched both of her parents, as well as other family members, go through cancer diagnoses and treatment, Barri says “I knew I was going to get cancer. It was just a question of when.”
It was Barri’s extensive family history of cancer that alerted Hope Rugo, MD, her oncologist at UCSF’s Helen Diller Family Comprehensive Cancer Center, to the possibility that her diagnosis was the result of hereditary breast and ovarian cancer syndrome, a genetic mutation in the BRCA1 or BRCA2 genes. During her initial consultation, Dr. Rugo mentioned the possibility and introduced Barri and her family to UCSF genetic counselor Nicola Stewart, MS, CGC.
That first conversation with Stewart was eye-opening. “Nicola is amazing in her ability to communicate things that can be so complex in a way that makes them so easy to understand,” Barri says. “By the time she was done sharing information and had taken a detailed family history, it was apparent that the genetic mutation came from my father’s side of the family—he had prostate cancer before he was 70, and his only sibling died of pancreatic cancer before he was 60; those are the two main risk factors for men with a BRCA1 or BRCA2 gene mutation.”
Barri underwent genetic testing herself for the BRCA1 and BRCA2 genes, and her result was positive, showing that she carried the genetic mutation in her family. The positive result, though not surprising, provided critical information as Barri moved forward with planning her treatment. “The information definitely impacted my treatment plan,” she says. “Even though the tumor was tiny, there was no way I would opt for a lumpectomy [given the genetic information I learned].”
Instead, Barri opted for a double mastectomy and simultaneous oophorectomy, to reduce her risk of both breast cancer recurrence and ovarian cancer. “I have a long life ahead of me,” she says, “and I didn’t want to go through this again. The genetic results, combined with my aggressive diagnosis, led me to choose aggressive treatment.”
Having completed treatment and moving ahead with her active, busy life, Barri is grateful for the information she was provided through genetic counseling and for the conversations about genetic risk that her family has undertaken as a result. Though she doesn’t believe genetic testing is the right choice for everyone, she now encourages others to seek more information about their family history. “When I talk with other women who have had breast cancer before menopause or those who can list numerous relatives who have had breast or other cancers, I’ll ask if they’ve considered talking with a genetic counselor,” she says. “I don’t tell anyone that they have to have genetic testing, but I might suggest that they talk with a genetic counselor, as it can be such a powerful tool.”