It was back in 1995 that Dr. Sheldon Wasserman, an obstetrician/gynecologist and former state assemblyman, was asked to a meeting at Clarice Zucker’s home. Zucker, a founding member of the Wisconsin Breast Cancer Coalition, was alarmed at the number of North Shore women with breast cancer.
Wasserman asked the Wisconsin Department of Health to look into the issue. Dr. Patrick Remington, an epidemiologist and professor at UW-Madison’s medical school, found a definite pattern.
“He found that [ZIP codes] 53217 and 53211 had statistically high incidences of breast cancer,” says Wasserman. According to Remington’s 1997 report, these North Shore communities have “nine to 10 more cases diagnosed each year than expected.”
Meanwhile, research was being done connecting genetics to cancer. “We tested over 3,000 women, looking for genes that cause breast cancer,” says Peter Meldrum, CEO of Utah-based Myriad Genetics Inc. He published a report in the academic journal Science in 1994 that connected a mutation of the BRCA1 and BRCA2 gene sequences to breast cancer. “Though the mutation is prevalent in all populations, Ashkenazi Jewish women have the highest risk,” Meldrum notes.
The North Shore district Wasserman formerly served is heavily Jewish. A survey of Milwaukee congressional districts from 2000-2006 found: “The vast majority (68 percent) of Milwaukee’s 21,000 Jews lives in four ZIP codes (53029, 53209, 53211 and 53217). ”
“The theory as to why there’s a high incidence of breast cancer in the North Shore is there are many women of Jewish ancestry,” says Deborah Wham, lead genetic counselor at Aurora Health Care. “And Jewish women of Ashkenazi ancestry, whose ancestors came from Central or Eastern Europe, are more prone to having mutated BRCA. Where one in 500 carries the mutated BRCAs, in the Jewish population it’s one in 50.” Milwaukee gynecologist Debbie Larkey puts the odds even higher: “The statistics for Jewish women are one in 40.”
For Brown Deer native Rosemarie Dubman, 41, those statistics are personal.
“Until 2001, I’d never heard of the BRCA gene,” says Dubman, whose mother and father are of Eastern European Jewish origin. “Then my father’s sister got ovarian cancer. She had the mutated BRCA1 gene. In 2009, my mother found she had stage 3 ovarian cancer. She tested positive for BRCA2.” Both her grandfather and grandmother on her father’s side also had cancer.
“If you have a BRCA mutation, your lifetime risk for breast cancer is between 56 and 87 percent,” says Wham. “If you have a BRCA1 mutation, your risk for ovarian cancer is up to 44 percent; if BRCA2, then the risk for ovarian cancer is up to 27 percent.
“This has been one of the biggest discoveries in genetics ever,” Wham adds. “Unfortunately, many North Shore women at risk are not being tested.”
There are no early screening methods available for ovarian cancer, Wasserman notes. Most international guidelines recommend BRCA carriers have their ovaries removed once childbearing is over.
But for breast cancer, there are more options. “Many women choose increased surveillance methods, such as breast MRIs in addition to mammograms,” Wasserman says. “Some women will opt for prophylactic mastectomies to reduce breast cancer risk by approximately 90 percent.”
As for Rosemarie Dubman, she’s hopeful the trail ends with her. So far, she is cancer-free, as are her siblings. “We thankfully tested negative for the mutated gene.”