Breast cancer is the second most common cancer among women in the United States, according to the Centers for Disease Control and Prevention. One in eight women will develop breast cancer, which claims the lives of an estimated 43,600 women each year.
In September 2019, then-18-year-old Kelsey Knutson, of Virginia, Minnesota, decided to get screened. That might seem young, but Knutson knew it was time due to her family history.
“My mom had breast cancer and my grandma had both breast and ovarian cancer,” said Knutson. “It turns out there is a genetic mutation that runs in my family that puts me at high risk.”
Knutson’s older sister, Kaitlin, had been tested for the mutation a few years earlier. When Kaitlin was confirmed to have it, Kelsey knew she was likely to, as well. Her test came back positive.
"My mom had breast cancer and my grandma had both breast and ovarian cancer. It turns out there is a genetic mutation that runs in my family that puts me at high risk."
— Kelsey Knutson, age 20
The BRCA1 mutation is a cancer gene that is often inherited.
“People with the BRCA1 mutations have hereditary breast cancer, which places them at a higher-than-average risk for developing breast cancer as well as ovarian cancer,” said Carolyn Olson, an advanced practice registered nurse in Essentia Health’s breast health program. “On average, a woman carries a 12.5% lifetime risk of developing breast cancer.”
The mutation doesn’t mean Knutson has cancer, but at just 20 years old she has an 83% lifetime risk of developing breast cancer.
“I was in shock at first. I just thought this meant I was going to get breast cancer one day and lose all my hair,” said Knutson.
Knutson immediately scheduled follow-up appointments with her providers at Essentia Health to determine the best path forward and how to reduce her chances of developing breast cancer. They recommended a healthy diet, regular exercise and limiting alcohol intake.
“I think a lot of people would think this is a death sentence,” said Knutson. “For me, it’s really opened my eyes and helped me take control of my health care. It’s also an eye-opener that has helped me really enjoy living in the present and focus on things that I enjoy.”
For women at average risk, annual mammograms and clinical breast exams should start at age 40, according to the National Comprehensive Cancer Network.
“We also recommend breast self-awareness at any age, maintaining a healthy lifestyle of moderate exercise, keeping your body mass index below 25, smoking cessation and minimal alcohol intake,” said Olson. “For persons that are high risk, which is someone with a greater than 20% lifetime risk of developing breast cancer, depending on their age and other factors, they should have a CBE (clinical breast exam) every six months, an annual mammogram and an annual breast MRI.”
For now, Knutson gets yearly breast exams and does self-examinations regularly. Upon turning 25, she will undergo yearly MRIs to monitor for cancerous growths and start her mammograms at 30.
"According to the American Cancer Society, on average, early detection of a Stage 1 breast cancer has a 99% five-year relative survival rate."
— Carolyn Olson, Essentia Health nurse
“I would recommend taking care of your breast health to anyone,” said Knutson. “It’s better to keep an eye on things and catch them early than to wait for them to progress and potentially be more difficult to treat.”
Because of advancements in treatment, the survival rate is much higher for breast cancer patients than it once was, especially if detected early.
“According to the American Cancer Society, on average, early detection of a Stage 1 breast cancer has a 99% five-year relative survival rate,” said Olson.
“If you do have this mutation, don’t be scared and make rash decisions,” said Knutson. “Just take the necessary precautions, do routine screening and stay in touch with your doctor. Live life normally and freely. Yes, I was scared at first, but you can’t go through life that way. It will only set you back.”
Knutson is currently a junior at the University of North Dakota in Grand Forks. She is majoring in pre-med biology and hopes one day to attend medical school with an emphasis on genetics - a decision driven in part by her own family history.
“I wasn’t interested in genetics until I found out I had this mutation,” said Knutson. “It drives me to learn more about all genetic diseases and hopefully be able to help more people in the future.”
When she’s not at school, Knutson can be found hunting, snowmobiling or spending time with her large and tight-knit family - things she enjoys now more than ever before.
“People feel sorry for me for having this mutation, but I don’t think of it that way. It’s allowed me to live a little bit more and push me in what I want to do in life and driven me to want to help people in my career when I’m done with college,” said Knutson.
Signs and symptoms to look for include changes in the size or shape of the breast, lumps, a change in skin texture and more.