Cancer Diary Offers Lessons for Everyone

I was deeply moved by Mary Herczog’s article describing her experiences being diagnosed with breast cancer (“The Diagnosis,” Dec. 8). Her bravery and vulnerability were both apparent in her first-person account. Most important, she draws attention to the fact that you are never too young to begin regular breast checks. Thank you for printing this series and reminding women that breast cancer is a reality for all women regardless of their age.

KATHLEEN SAUER

Carlsbad

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Mary Herczog’s story on her battle with breast cancer highlights the importance of the family history--an often-neglected medical school fundamental that she herself downplays. This is of resurgent importance given genetic advances in the understanding of cancer. Her young age at onset and the history of male breast cancer in the paternal grandfather (from whom she also presumably inherited the Ashkenazi Jewish surname, along with the risks for predisposing genes in this population) makes me suspect that she is part of a breast cancer family potentially linked to mutant BRCA1 or BRCA2 genes. This issue requires decisive resolution, as it would have significant implications with respect to recurrence of a second primary tumor in the same or opposite breast; her risk for ovarian cancer; the potential value of prophylactic mastectomy and ovary removal, and issues related to risk counseling, DNA and mammographic screening; and prophylactic mastectomy and oophorectomy in at-risk relatives.

Dr. Marshall Horwitz

Assistant professor of medicine and medical genetics

Attending physician, Cancer Family Genetics Clinic

Markey Molecular Medicine Center

University of Washington School of Medicine