“Prevention saves lives. Health is everything, and I thank God I learned this lesson without falling ill!”
This was the message shared by Sofia Fyrou, who just yesterday revealed that she underwent a preventative mastectomy last November.

As the influencer disclosed, her mother had been diagnosed with breast cancer at the age of just 39. Her family’s heavy medical history prompted her to undergo genetic testing, which revealed that she carries the faulty gene and that her chances of developing cancer exceeded 85%. This diagnosis led her to the decision to surgically remove both of her breasts.

A similar procedure was undertaken in 2013 by Angelina Jolie, whose family history led her to undergo genetic testing, which showed that her chances of developing cancer were over 87%. Two years later, in 2015, the actress had her ovaries removed as well, after the genetic test showed a 50% risk of cancer. Jolie’s case is believed to have motivated many women with a family history of cancer around the world to undergo genetic testing, potentially preventing illness.

“In Greece, there are approximately 5,000 new cases of breast cancer each year. Of these, hereditary cancer cases account for less than 5%. However, this type of cancer is aggressive, appears in younger women aged 35-47, and is associated with a high mortality rate. For this reason, many women choose the radical solution of a double mastectomy, which is often followed by the removal of fallopian tubes and ovaries,” explains Dr. Evangelos Filopoulos, surgical oncologist and director of the Breast Clinic at “Agios Savvas” Hospital.

The Genes That Hold the Answers

The BRCA1 and BRCA2 genes are the ones associated with breast cancer risk. According to Dr. Irini Th. Karyda, MD, PhD, surgeon and director of the Breast Center at HYGEIA Hospital, approximately 5% to 7% of breast cancer cases are linked to mutations in these genes. However, in cases of a heavy family history — several instances of breast or ovarian cancer — the percentages skyrocket. In some families, more than 90% of members may carry these genetic mutations.
Which Women Should Get Genetic Testing?

According to international guidelines from the National Comprehensive Cancer Network (NCCN), if a woman has a family history or has been diagnosed with breast, ovarian, or pancreatic cancer, she should consider genetic testing.

Dr. Filopoulos adds that not all women with a family history of breast cancer are candidates for the BRCA1 and BRCA2 genetic test. This test is primarily aimed at women who have a first-degree relative diagnosed with bilateral breast cancer at a young (pre-menopausal) age, as well as those with multiple first- and second-degree relatives with a history of breast and/or ovarian cancer.

If it is found that a woman carries BRCA1 or BRCA2 mutations, the risk of developing breast cancer jumps to 50%-85% and ovarian cancer to 15%-40%.

The Next Step

If genetic testing indicates a high risk, doctors suggest three management options:

Preventive Mastectomy

Surgical removal of the breasts is the safest option, reducing the risk of breast cancer by 97%. However, it does not offer absolute protection, as a small amount of breast tissue remains in the body. Similarly, the removal of the ovaries significantly reduces the risk of both ovarian and breast cancer.

Intensive Monitoring

Women who do not feel ready to proceed with the drastic solution of surgery can opt for close monitoring. This includes monthly self-examinations, clinical exams 2–4 times a year, annual mammography and MRI scans, as well as ovarian monitoring via ultrasound and blood markers.

Chemoprevention

Medications such as tamoxifen can reduce the risk, although their protection is considered limited compared to mastectomy.

“There is no one-size-fits-all strategy for all women. The decision is deeply personal, and doctors must act as companions, providing all necessary information and supporting the patient in whatever decision she makes,” concludes Dr. Karyda.