What is A Stitch In Time?

Better a moment too soon that a minute too late” William Shakespeare

A stitch in time saves nine’ proverb: to solve a problem immediately will save work later.  If you apply this principle to breast cancer; by reducing a women’s risk to develop the disease, it could save her and her family the devastation a diagnosis will cause.

1 in 8 Australian women will develop breast cancer, however, this statistic relates to the general population.  The understanding of what being at ‘increased or high risk’ for developing breast cancer is not widely understood.  Around 5-10% of breast cancers are due to an inherited faulty gene, commonly a BRCA1 or BRCA2 gene mutation, or a strong family history of breast cancer.  5 -10% may sound small but it’s actually tens of thousands of the of the women diagnosed with breast cancer in Australia each year. 

Better knowledge of their risk and prevention options will reduce the number of women diagnosed with the disease?  It generates a great deal of confusion and stress for many families when they learn of a breast cancer diagnosis in a relative and have to consider what it might mean for them.

Currently, trying to understand the implications and navigate the prevention pathway is challenging for women who learn of a family breast cancer history and/ or a gene fault.  Common questions arise, such as: 

“I’m young and I haven’t started a family yet, should I tell my partner I’m at high risk of developing breast cancer? “

“Should I have a preventative double mastectomy, it sounds extreme?”

“Should I do nothing and hope for the best, after all there’s no certainty I’ll get breast cancer?”

For many women simply ‘putting it out of mind’ isn’t possible.   Project participant Dyna Eldaief told us, “My breasts feel like ticking time bombs!” and her sister described it as being like a persistent concern that doesn’t go away and gets worse with time – Donna told us, “It’s like having a monkey on my back”.

The majority of women at high risk currently don’t do anything to prevent breast cancer opting to ‘monitor’ through screening.  While this is, and always should be, a personal decision made by each woman, this project’s expert consultants suggest that there is a pressing need for new ways of communicating the many options and pathways available to women in this situation.

‘We need a more systematic approach so that every woman knows what her breast cancer risk is. Is she at average risk, is she at high risk or is she somewhere in the middle? That’s really the cornerstone of prevention, once you know what your personal breast cancer risk is, that helps you make decisions about what the best management strategies are.’ Prof Kelly-Ann Phillips Medical Oncologist, Peter Mac 

It’s said that knowledge is power and the knowledge that prevention is always better than cure lies deep within the Hippocratic Oath.  However, the focus for breast cancer is currently on research related to cure and treatment.  For women and families who are at increased risk the wait-and-see game can take a heavy toll.  Annual trips to the Familial Cancer Centre, routine mammograms and MRIs are a constant reminder and this is often triggered by a breast cancer diagnosis in a loved one.

We’ve begun filming with Dyna Eldaief who is at high risk of developing breast cancer.  We’re seeking more participants to share their stories in order to show different choices and pathways. We’d like to see all women armed with the information they need to inform how they will ‘make a stitch in time’.

Dyna’s Story

Dyna is a regular Aussie mum living with her husband Jamie and three young children in regional Victoria.  She has a very personable and relatable character and has carved out a niche for herself as an Egyptian cook, following the Egyptian heritage passed onto her by her parents.  It’s currently a hobby but with her own YouTube channel that saw her cast in the ‘Taste of the Middle East’ late last year (a food contest show similar to MasterChief, filmed in Egypt) she may well be starting up a career.

Dyna’s breast cancer journey began in her early 20’s when her mother was diagnosed with the disease and eventually succumbed to it.  Dyna learned then that there were multiple family members who had the disease including her mothers’ sister and a number of cousins who have been diagnosed in their 30’s. A genetic counselor has determined that she is at a high risk due to family history. For ten years now Dyna has been receiving regular check ups including mammograms, breast exams and MRI (Medical Resonance Imaging) She and her husband have three beautiful young children and with no plans for more, Dyna is ready to explore more preventative options available to her.

When we began filming with Dyna she had been asked to consider taking Tamoxifen and was researching surgical options as well as lifestyle choices including diet and exercise. It’s a complex and emotional path to be on, there are many questions and it’s not easy to know what choices to make.  Dyna, doesn’t have cancer and she isn’t a cancer survivor so she falls into a strange middle ground between healthy and diagnoses. It’s an uncertain journey many women like Dyna are living with privately.

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