Breast Cancer Screening
Classroom Activity

This scenario could be used as an individual exercise or with small groups of students. If using groups, try assigning students to the different roles (aunt, sister, children ) for discussion. Some real-life examples may provide useful background information.

Mary Jane Smith is a 42 year old woman who has been diagnosed and treated for breast cancer. Mary Jane has a married sister, Samantha who has three children--two daughters, Fran and Irene, and a son, Don; all three are in their teens. Mary Jane and Samantha's mother died of breast cancer at the age of 48.

Mary Jane's doctor is a breast cancer researcher at a local university hospital. She invited Mary Jane to have a genetic test to determine if her breast cancer was the inheritable type. Test results showed that Mary Jane has a gene called BRCA-2 which accounts for about 2% of the breast cancer cases diagnosed each year. The BRCA-2 test was not available while Mary Jane and Samantha's mother was alive, so there is no way to tell if Mary Jane inherited the gene from her mother or her father. Mary Jane has the gene, so there is a 50% chance for each of her children that they have inherited the gene from her. This gene triggers breast cancer in both males and females, and 85% of females having the BRCA-2 gene develop cancer. Athough only 1% of breast cancer occurs in men, most of these cases occur in men with the BRCA-2 gene.

Research on the BRCA-2 gene is very new, and the doctor asks Mary if she can study the family to determine their risk for this disease. She needs the cooperation of all family members in order to include them in the study.

Mary Jane knows that early detection is extremely important for survival. She has recommended that all family members be tested.

Samantha is 40 years old and does not want to be tested. However, her daughters are interested in participating in the research and knowing their risk for breast cancer. Samantha's son does not have an opinion. If any of the children has the gene, Samantha will know that they have inherited it from her.

Discussion Questions:

Who should be tested and why? Can the teenagers decide for themselves?

If the test results are positive (that is, the person has inherited the BRCA-2 gene):

The person may be able to get more effective treatment at an earlier stage, catching the cancer long before it has a chance to kill. Women might choose to have their children early; men might choose additional testing (monitoring) .

How might this information affect a person's mental state ?

Some people might become devastated over the realization that they might someday develop breast cancer, leading to anxiety attacks, depression, etc.

What impact could this knowledge have on future employment or insurance (health and life) eligibility?

Would a person be forced to disclose (inform) employers and insurers about the test results? Would you want to know?

Could negative test results lead to complacency ?

A person might decide not to monitor his/her health carefully, neglecting the early detection practices such as self-exam and mammography.

Complacency would be especially harmful if the test results are actually a false negative.

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