Breaking the Code: McLeod Oncologist Explains the Genetics of Breast Cancer


Breast cancer research is going forward in multiple different ways. As a result, today we have more chemotherapy agents and targeted treatments to help women, such as immunotherapy.

Our goal is to provide personalized cancer care. We do not look simply at the patient, we also study the tumor to see if they have certain receptors on them so that we can fine-tune, customize and personalize the treatment for each person. One treatment does not fit all — we individualize it to each and every person.

Types of Breast Cancer

There are three different kinds of breast cancer. “Sporadic” is when a woman walks in with breast cancer and has no family history. This is the most common. The second is called “Familial,” meaning they have the family history but when you test them for the gene, it’s not there. The third one is called “Hereditary.”

Sporadic covers about 70 percent of women with breast cancer. Familial is approximately 20 percent of women. Usually, ten percent of women actually have the gene for breast cancer.

Breast Cancer Genes

There are two genes that carry a breast cancer risk. One of them is the BRCA gene and the other one is the PALB gene. If women have these genes, they have a markedly increased risk of breast cancer – much more than the average woman.

At McLeod Oncology and Hematology Associates, we provide genetic screening if a woman is likely to have the gene. The woman is seen by a genetics counselor and if she agrees, we draw blood and run a total panel of gene tests. This evaluation can give us a clearer idea of whether she will have breast cancer.

If a woman has one of the genes we recommend, once she is finished having children, she has her fallopian tubes and ovaries removed because the gene is also a marker for these cancers as well as breast cancer.

There are a number of different options you can talk about with women who have the breast cancer gene. One is to monitor them more often with MRI scans and mammograms. We also discuss whether they should take Tamoxifen, an anti-estrogen drug. For some women there is the consideration about whether they should have preventive bilateral mastectomies to lower their risk of developing breast cancer.

High-risk women who have a sister or mother who has breast cancer should discuss their medical history with their primary care physician or GYN physicians. If there are any questions, they can be referred to our team and we can counsel them on genetic testing.

This is a complicated area of oncology. There are a number of different points these women need to consider, and we can provide counsel. It also requires a lot of soul searching for each woman and her family of how they want to manage this situation.

For more information on breast cancer, contact Tracey Godwin, the McLeod Breast Oncology Navigator at (843) 777-5418.

Dr. Michael Pavy received his medical degree from State University of New York Upstate Medical Center in Syracuse, New York. He completed his residency in Internal Medicine at the Medical University of South Carolina in Charleston. Following his residency, he completed a fellowship in Medical Oncology at Johns Hopkins Hospital in Baltimore, Maryland. Dr. Pavy has been caring for patients at McLeod since 1981. He is the senior member of McLeod Oncology and Hematology Associates as well as Co-Medical Director of the McLeod Center for Cancer Treatment & Research.