The Struggles of (Literally) Removing the Risk of BRCA Mutations - Maya Lapinski

Maya Lapinski

HST 401 - Paper #2


The Struggles of (Literally) Removing the Risk of BRCA Mutations

Cancer is a reality that individuals with a BRCA (breast cancer associated genes) mutation must consider. As Philip Ball states in “How Life Really Works,” letting go of the “fiction that all this complexity is orchestrated by some master plan in the genetic sequence in our chromosomes” is a necessity (2023). While one would surely hope that the master plan of our genetic material is not destined to onset cancer, Ball’s words also demonstrate that it is not not that case quite either.


BRCA1 and BRCA2 are genes that lead to the production of specific proteins designed to repair damaged genetic material (National Cancer Institute, 2024). Mutations in these genes can result in the inability of a cell to fix any DNA damage it experiences. BRCA mutations can be inherited, and they heighten one’s risk of developing cancer– especially for breast and ovarian cancer. According to John Hopkins Medicine, testing positive for the BRCA mutation results in a 45 to 85% probability of developing breast cancer. This is a stark contrast to the 12% probability that exists for the general U.S. population. Even more striking is that this mutation accounts for a 10 - 46% chance of developing ovarian cancer, which affects less than 1% of the general public (2025). Not only do individuals with BRCA mutations have an increased likelihood of getting cancer, but they also have an increased likelihood of getting cancer earlier in life (National Cancer Institute, 2024). 


With these jarring statistics, the detection of a BRCA mutation can cause immense emotional turmoil. As seen by the elevated probabilities of developing cancer, preventative care is extremely important for individuals who test positive. Delving into the next steps, however, can be an immensely overwhelming process. With BRCA mutations being inheritable, they are often associated with cancer running within a family. When close loved ones experience an adverse health event, an individual is painfully equipped with a personal understanding of the struggle and pain they may come to experience. In particular, losing someone due to cancer can cause the reality of one’s situation to settle in as the uncertainty of genetics becomes disturbingly apparent.


When keeping in mind the fears that one has as they seek to better understand their BRCA mutation, it is imperative that health care encompasses the prioritization of their well being both physically and mentally. One of the more, if not the most, drastic prevention measures is prophylactic surgery, which is a surgery meant to reduce the likelihood of developing cancer by removing the tissue that may put the individual at risk in the future (National Cancer Institute, 2025). The most common preventative surgeries for people with BRCA mutations are mastectomies, removal of breast tissue, and oophorectomies, removal of the ovaries. With surgery, however, there is always the possibility that something goes wrong. While greatly decreasing the chance of developing cancer, getting surgery “does not guarantee that cancer will not develop because these procedures cannot remove all of the tissue that may become cancerous” (National Cancer Institute, 2025). 


Not only are there serious physical implications that need to be considered, but there are also prominent psychological impacts of these surgeries, which force individuals to contemplate serious decisions regarding their future. The ability to have children, change in bodily appearance, and early menopause are all real and serious factors that one needs to consider prior to surgery. With many societal pressures to look and follow a specific lifestyle, these factors can make surgery an even more daunting choice. This mental toll demonstrates the significance of psychological guidance needed throughout the whole process, which is often neglected or not provided by traditional health care.


Deciding to go forward with the surgery is simply an idea and not a reality until affordability and accessibility are considered. The average cost of a double mastectomy can reach as high as $55,000 (Harris Plastic Surgery, 2025), which rivals that of the yearly U.S. salary. You might be thinking: doesn’t insurance cover most of it? Well, according to the National Cancer Institute, “Many health insurance companies have official policies about whether and under what conditions they will pay for risk-reducing surgeries for breast and ovarian cancer risk reduction. However, the criteria used for considering these procedures as medically necessary may vary among insurance companies” (2025). Whether and under what conditions has a vagueness with potential for disparity in care among differing economic classes. This lack of standardization suggests that the system can take advantage of individuals who do not have access to any desired network of physicians and healthcare providers and are instead limited to their insurance plans. 


While Philip Ball mentions the importance of “the capacity of living things to act and to change their surroundings to their own benefit,” (2023) not everyone has the ability to make this true. Changes are needed in health care to eliminate the struggles of (literally) removing the risk of BRCA mutations. No one should have trouble trying to prevent cancer. 


Works Cited

Ball, P. How Life Really Works, Nautilus, 2023, https://nautil.us/how-life-really-works-435813/.

Harris Plastic Surgery. How Much Does a Double Mastectomy Cost? 2025, 

https://harrisplasticsurgery.com/2024/06/27/double-mastectomy-cost-hps/.

John Hopkins Medicine. Inherited Cancer Risk: BRCA Mutation, The John Hopkins University, 

2025,  https://www.hopkinsmedicine.org/health/conditions-and-diseases/ breast-cancer/inherited-cancer-risk-brca-mutation. 

National Cancer Institute. BRCA Gene Changes: Cancer Risk and Genetic Testing, National 

Institutes of Health, 2024, https://www.cancer.gov/about-cancer/causes-prevention /genetics/brca-fact-sheet#what-are-brca1-and-brca2. 

National Cancer Institute. Surgery to Reduce the Risk of Breast Cancer, National 

Institutes of Health, 2025, https://www.cancer.gov/types/breast/risk-reducing-surgery -fact-sheet#does-health-insurance-cover-the-cost-of-risk-reducing-surgery.

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