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Personal Decision, Broader Impact
Meggan Keith has witnessed the consequences of cancer many times in her own family. She lost her mother, her aunt and her grandmother to the disease. Today, as a postdoctoral fellow in UAlbany’s Cancer Research Center, she is in the thick of the war against cancer -- fighting for herself and the many others affected by the disease.
Keith’s personal history is shaping her research at the Center, which is focused on finding new and better ways to prevent and treat cancer. Keith is working to establish a tissue bank for tissue with the gene mutations known as BRCA1 and BRCA2. People, like Keith, who have those mutations, are more susceptible to developing cancer.
“Existing banks classify tissue as either ‘normal’ or ‘cancerous.’ Since my tissue didn't have a tumor, it would have gone into an existing bank as a ‘normal’ sample, even though I have a known BRCA2 mutation. We know that tissue from mutation carriers is high-risk and, therefore, not ‘normal’,” said Keith, who is seeking grant funding from the Department of Defense and National Institutes of Health.
Since the amount of tissue available for study is so small, researchers have to lump BRCA1 and BRCA2 mutations together into one "BRCA" class, even though there are known differences between BRCA1 and BRCA2 mutations in terms of relative risk for developing certain cancers, said Keith. With separate banks, researchers would be better able to study the differences between BRCA1 and BRCA2 mutations, and what they learn could provide the basis for advice to women on how to manage their care, she added.
"What Meggan is proposing to do is unique, since no one else is attempting to collect the breast tissue from women with the BRCA1 and BRCA2 mutations before the cancer develops,” said Martin Tenniswood, director of UAlbany’s Cancer Research Center. “This will be a painstaking and time-consuming process, but will provide a very valuable resource for researchers who are interested in understanding the other environmental factors that might lead to cancer in women with the mutations."
In her own case, with the support of her husband Jamie, also a cancer researcher, Keith made the radical decision to have a double mastectomy and implant surgery last December at age 28. No tumors were found in the tissue, but she still doesn't regret her decision.
"I was able to make the call myself, I put myself in the driver's seat," said Keith, who earned her doctorate in biology at the University of Notre Dame. "I watched my mom go through chemotherapy three times. It's not something I wanted for myself. But a lot of people aren't comfortable making that decision at such an early age."
The idea behind the tissue bank is not to just collect tumors from patients identified with BRCA1 and BRCA2 mutations, but to collect tissues from women, like Keith, who have prophylactic mastectomies before they develop tumors. Making cell lines from these tissues will provide a source of BRCA1 or BRCA2 mutated cell lines that will let researchers study how normal cells carrying the mutations progress to become cancers.
Keith’s mother was twice diagnosed with breast cancer and died after her cancer metastasized into her chest wall at age 37. Keith was just 10 years old. Her aunt was diagnosed with cancer three times, before succumbing to lung metastasis in her 30s. Her grandmother died of Hodgkin’s disease before Keith was even born.
All three had the BRCA2 gene mutation that Keith has.
For Keith, this meant routine mammograms and ovarian ultrasounds, starting at age 20. During doctor’s office visits, Keith would look around the waiting room and find herself surrounded by women three times her age.
"I was not immune to the 'why me' moments. Some of the worst happened while I sat in those waiting rooms, thinking, 'I'm too young to be here'," said Keith, who lives in Averill Park.
Over the years, Keith suffered several scares after doctors found perceived abnormalities. The endless cycle of exams and call backs became emotionally draining for Keith, so she opted for surgery. Afterwards, Keith wanted to donate the tissue to research, but there wasn't a separate bank for tissue with BRCA mutations. By starting one herself, she’s hoping others may be spared the same painful decision she had to make.
"There's nothing else you can tell women in my situation. You can either do it or roll the dice," said Keith, who is still facing removal of her ovaries in 10 years as a preventative measure. "It's just not a decision anyone should have to make."