Medical decisions are inherently personal and can be based on any number of factors. For Robyn Radway of Tempe, seeing her mom pass away from breast cancer prompted her to have her own genetic testing done. It found the 47-year-old was at a higher risk for breast cancer. So, she took preventative action. She had surgery to remove her ovaries and then had a bilateral mastectomy. And she says it was an easy choice to make.

"For me, I felt it was a no-brainer," she said. "I’d never really had any kind of surgery before, but I wasn’t really scared of it. I’m more scared of cancer and I saw my mom really suffer a lot."

Her testing looked at the BRCA1 and BRCA2 genes. The National Cancer Institute describes these genes as producing tumor suppressor proteins, which help repair damaged DNA. They also ensure the stability of a cell’s genetic material. Robyn’s test showed a mutation in the BRCA2 gene, something that happens in about one in 400 people.

But among Ashkenazi Jews, which includes Robyn, that ratio is about one in 40. People who have a mutation in the BRCA2 gene have up to a 70 percent chance of getting breast cancer by age 70 and there’s also increased risks of ovarian cancer in women and prostate cancer in men. For Robyn, thinking about her two kids played into her decision to have surgery.

"You know, I want to live," she said. "I want to be here for my kids, for my grandkids. That’s it. So, I made the choice to be proactive."

Radway said it wasn't a tough decision to remove parts of her body.

"No. For me, it wasn’t a tough decision," she said. "And, I had actually made my decision before I got the results of my test. I had decided if I was positive, that’s what I wanted to do."

Robyn’s younger sister, though, made a completely different decision. 45-year-old Erica Radway, who lives in San Diego, has not had genetic testing. She focuses on staying healthy through diet and meditation. 

"Having as much information as possible is great, but this is what gives me peace of mind, making the choices that I’ve made," she said. "And I think, to me, that’s the most important."

Erica also has thermal imaging every six months. She acknowledges it’s not a widely accepted method of screening, but she’s comfortable with it. That’s not to say she wouldn’t seek other care if she ever had cancer.

"I would look for definitely qualified medical professionals," Erica said. "But people with a more holistic approach and don’t have a mindset that you either have to cut it out, poison it out or burn it out, or you won’t survive. I’m not comfortable with those things. I’m not saying I would never do them, but it wouldn’t be my first choice."

And even though Erica has never been tested, she assumes her BRCA genes have mutations, like her sister. 

"I think one: because of family history," she said. "And two: just to be even more proactive than I would be. I like to err on the side of caution. And I know for many people, this doesn’t sound like I’m taking precautions, but I think just so I would do the maximum, what I feel comfortable with."

Both sisters used that same phrase, “proactive,” to describe their approaches, even though those approaches are very different.

Arlie Colvin is familiar with this kind of decision making. She’s a Cancer Genetic Counselor for Honor Health and worked with Robyn Radway.