Cousins Raelee Kingdom and Lisa Lloyd have a 70-85 per cent chance of developing breast cancer in their lifetime.
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The Hunter women both have the BRCA1 gene mutation - an inherited condition that vastly increases their risk of breast and ovarian cancer. Their children have a 50/50 chance of having the gene.
Currently, the only management for the mutation is regular screening to detect cancer early, or removing both breasts as a prevention.
But a new trial is bringing hope to women like Raelee and Lisa. They were the first in Australia to sign up to BRCA-P, an international, double-blind trial to determine whether osteoperosis drug Denosumab can be used to prevent breast cancer.
Both found out they have the gene about five years ago, and opted against surgery.
"I decided to go with screening," Ms Kingdom said. "I've definitely thought about surgery.
"I was really, seriously considering it, but I definitely don't want to have to do it."
"I have a history of it in the family but it's fairly shocking to find out you're positive," Ms Lloyd said. "Surgery is a hard decision. People who can make it are very brave."
The women were asked by their specialists to join the trial and jumped at the chance, not for themselves but for their families.
"This could affect my kids," Ms Kingdom said. "I have a son and a daughter, both of them have to be tested for the gene. As a mum you think about them first."
"I have children and other family members - you can only hope there's something out there that can help them," Ms Lloyd said.
The trial means they either take the drug every six months or a placebo, continue annual screening and visit a trial doctor twice a year.
Dr Nick Zdenowski, an oncologist at the Breast Cancer Centre at Gateshead and medical adviser for the trial, said it was safe even with placebo use, because of the standard of care and the fact the drug is already well-used.
"They're followed very closely to see if there's anything abnormal and dealt with as required," he said. "Many women decide to have their breasts removed, but they'd prefer not to. It's a significant surgery and even if they pursue reconstruction, it's never the same as having their own breasts."
Studies show Denosumab can inhibit the cells that cause breast cancer in women with the BRCA1 mutation, and Dr Zdenowski said researchers were recruiting almost 3000 women globally, including 300 in Australia, to quantify that research. Currently less than 10 Australian women are involved.
Researchers are appealing to eligible women - those with the gene, aged 25-55, who haven't had cancer or preventative surgery to join.
"We have a long way to go," Dr Zdenowski said. "It's very safe and because it's preventative, they don't need to go on it right now."
A Newcastle podcast has joined forces with Breast Cancer Trials to promote the research initiative.
Alana Nixon and Laura Jackel will record a special episode on their Oversubscribed podcast next week, to coincide with Breast Cancer Awareness Month.
"We are thrilled to have a part in spreading the message about this new clinical trial and also about breast cancer and the importance of breast cancer research generally," Ms Jackel said. "Both of us have friends and close family members who have been affected by breast cancer and know how important it is to find research participants and raise awareness of the work that researchers do more broadly."
Visit the Breast Cancer Trials website for details.