Trio share danger geneSave
Lindy Laird meets a Whangarei family where mum, dad and daughter have all had breast cancer
Put Kelvin and Patrina Hardie alongside their daughter Mandi Cross and the family likeness is obvious.
Mandi takes after her mum and dad. It's that genetic thing, of course - that deep inherited pool that has given Kelvin and Mandi the eyes, their chins, given Mandi and Patrina their smile.
That's what people see. But there's a dangerous hidden genetic factor all three share that has threatened their lives and, despite the prevalence of the disease it triggers, also makes this family trio rare.
They have all had breast cancer.
Mandi and Kelvin have the BRCA2 gene and Patrina has BRCA1 - the two inherited gene mutations which confer the highest risk of developing breast cancer. There are other more recently identified gene mutations which also raise risk, but the biggest risk is associated with these two.
About 12 per cent of women in the general population will develop breast cancer, usually when they're in middle years or over, but 55 to 65 per cent of women with the BRCA1 mutation and about 45 per cent of women with the BRCA2 mutation will get it.
Men who have an abnormal BRCA gene have an 80 times greater risk of breast cancer than the average fellow.
Before any of the Hardie and Cross family found this out, though, Patrina was the first to suffer from breast cancer, needing surgery and radiation when she was in her mid-40s.
It recurred some years later. "They just chipped away at it," she says matter-of-factly.
In between Patrina's bouts, Mandi developed the disease, spending her 30th birthday in hospital having a mastectomy.
"Just as well they got it when they did because it hadn't metastasised. It hadn't gone anywhere else in my body," she says.
That was 15 years, and while she doesn't dwell on what might have been, she admits to looking at life afterwards with the attitude that "life's what you make it".
The day after our chat Mandi flew out for a six-month travel stint. She was to fly into Nepal for an Everest Base Camp trek en route to Europe - but the devastating earthquake hit only days earlier, and created last minute plan changes.
"There's more things to think about in life than having cancer," she says, in the wake of the Nepal disaster.
Mandi jokes that after she and her mother had breast cancer, "Dad felt left out."
Kelvin's turned up soon after Patrina's second bout, 10 years ago.
He was at the doctor for a check up when the doc noticed Kelvin's nipple was a bit distorted. Tests showed the unbelievable -- he had breast cancer.
"That was at Christmas so I kept quiet about it so as not to ruin everyone's time," he says.
"It still did," his wife and daughter chip in. He hadn't done a good job of pretending there was nothing wrong.
So, Kelvin went in for a mastectomy, too, still has medication, but like Mandi has had no sign of cancer since.
He is one of about 20 Kiwi men a year diagnosed with breast cancer, about 1 per cent of all breast cancers.
"For men it can be just as invasive as it is for women. It can spread," Kelvin says.
"But women have a double whammy. Men, they just have to get rid of the cancer. For women there's a bigger loss and fear of disfigurement, there's a lot more to it."
Sometimes with BRCA gene mutation, there are big decisions to make even before the disease strikes. One high-profile case was the precautionary double mastectomy movie star Angelina Jolie opted to have when she learned she'd inherited the BRCA1 gene that caused her mother's death.
The majority of women who get breast cancer have no family history or may have one, usually older, relative with it. If someone has a first degree relative with breast cancer their risk is increased from the 1.8 per cent the general population has to 2.8 per cent -- but even then not to the level of risk carried by people who have the inherited gene mutation. Those women also a high risk of ovarian cancer.
However, according to New Zealand Breast Cancer Foundation, probably only 5-10 per cent of all breast cancers are inherited.
Mandi sees having the gene -- knowing she has it -- "as a positive".
"It makes me see very clearly it's about doing your best to have a good life. The fact mum and dad are still here after dad having the same gene and having breast cancer and mum having it twice, and they're fine now, that proves it's not the end of the world."
"If you have down thoughts you just lift yourself up. When you get cancer it makes you reassess things.
"In my view it's about embracing that. Take a good look, refocus and get on with life."
This family doesn't mope about being dealt a dud card. They're lucky to have all survived it, they admit, and they're stoic.
"Mum always says it's like the 'flu to us'," says Mandi.