Megan Guerin was still a teenager when she began to think seriously about how to more proactively manage her health. Guerin’s motivation was based largely on her own family’s health history. The word “cancer” kept coming up.

Her mother was diagnosed with ovarian cancer and one of her grandmothers died of the disease in her early 40s. As the years went by there were more warning signs including an aunt diagnosed with breast cancer.

“I also learned about all these other women in my family who had breast or ovarian cancer and men who suffered from prostate cancer,” she recalled.

Quest for Knowledge

Guerin herself remained healthy. But as she approached her 30^th birthday she felt it was time to act. After consulting with her NorthShore-affiliated Internist Praful Kurani, MD, Guerin decided to explore genetic testing to determine if she, too, might be at greater risk of developing cancer. She turned to the experts at the NorthShore Center for Personalized Medicine—one of the most comprehensive programs in the country using genomic information to predict, prevent and treat a variety of diseases.

The Chicago woman first met with Medical Geneticist Peter Hulick, MD, the Center’s Medical Director. “I had sought genetic testing years earlier at another hospital, but was told there wasn’t enough evidence to warrant it,” Guerin explained. “But Dr. Hulick said there’s something going on here and ordered the test. I’m someone who’s always hungry for knowledge so I definitely wanted to do it.”

With guidance from Dr. Hulick, Guerin met with NorthShore genetic counselors even before taking the test. “We’re partnering with patients throughout this process, and we want them to fully understand what we’re looking for and what it could mean,” noted Dr. Hulick, who holds an academic appointment at the University of Chicago Pritzker School of Medicine. “Fortunately NorthShore is a place that has not only invested in personalized medicine, but also values the full spectrum of care.” 

Facing the Facts
The genetic test results found that Guerin had a mutation in the BRCA1 gene, meaning she was at greater risk for developing breast and ovarian cancer. While women in the general population have a 12 percent chance of getting breast cancer at some point in their lives, those with a BRCA1 or BRCA 2 mutation have a 50 to 80 percent risk. They also are at risk of developing breast cancer at a younger age and have a 20-50 percent lifetime risk of ovarian cancer, too.  

“It was a game-changer,” said Guerin, now 34. “I had just turned 30 and suddenly I have to think about all these things like ‘Will I develop cancer?’ ‘Can I have kids?’ These are things people my age normally don’t have to think about,” the young woman recalled.

In further consultation with Dr. Hulick and with support and resources from NorthShore’s genetic counseling team, Guerin weighed her options. She could undergo stricter surveillance going forward, including breast examinations every six months—alternating between mammograms and breast MRIs. Or she could opt for prophylactic or pre-emptive surgery to remove her breasts and ovaries before cancer could develop.

DNA-Driven Decision
“It was the most difficult decision I’ve ever had to make, but I decided to have the surgeries,” said Guerin. “I just didn’t want to live like that, where every 6 months I don’t know if I’m going to find out I have cancer.”
 
Firm in her decision, Guerin admitted she still felt nervous when she first met with a care team at NorthShore Kellogg Cancer Center including Gynecological Oncologist Elena Moore, MD, and Surgical Oncologist Katharine Yao, MD.

“I walked in and initially thought, ‘Wait a minute, I don’t actually have cancer and I’m too young to be here,’” Guerin recalled. “But those feelings quickly went away. The staff made me feel so comfortable. Each doctor I spoke with was like talking to a friend.”

A few weeks later, Guerin underwent a prophylactic double mastectomy—preventive removal of her breasts with Dr. Yao, and Dr. Moore removed her fallopian tubes. Mark Sisco, MD, Division Chief of Plastic Surgery, also was part of the care team, performing breast reconstruction surgery. Guerin will have a final surgery with Dr. Moore later this year to remove her ovaries. All three specialists hold academic appointments at the University of Chicago Pritzker School of Medicine.

“I commend Megan for seeking out this information, fully educating herself and then for making a courageous decision,” said Dr. Moore. “I was proud to be a part of a great team at NorthShore that supported her throughout the process and continues to today.”

Thinking back to her decision, Guerin has no regrets. “I’m beyond happy I did it,” she said,
“and the staff at NorthShore has been unbelievable in the amount of support they have provided.

She also is leveraging her own experience to become a positive force to help others, including volunteer work with national nonprofits that focus on prevention and early detection of breast and ovarian cancer, and she jokingly models herself after some fictional superheroes.

“With my genetic mutation I compare myself to the X-Men,” she said, smiling. “I have this amazing knowledge now and it’s been so empowering.”