It’s not difficult to guess that Michelle Weaver Knowles’ favorite color is pink.

Wearing pale pink eye shadow to match a metallic pink stethoscope draped around her neck and a rose gold Apple watch on her wrist, Weaver Knowles said the color carries a special meaning for her as a breast cancer survivor and family nurse practitioner dedicated to helping others prevent and battle cancer.

Weaver Knowles is one of about a dozen genetic counselors in Montana and an advocate for the increased use of gene testing, which can spot gene mutations and allow men and women to consider options to prevent their risk of cancer.

On Tuesday, the first day of both October and Breast Cancer Awareness Month, Weaver Knowles departed from her usual pink-on-pink-on-pink ensemble.

Instead, she opted for a green DNA double helix print dress that she wore to meet with providers at Western Montana Health Clinic, where she spoke about the role of genetic testing in cancer prevention.

"Genetic testing is not used as much as it should be with cancer," Weaver Knowles said.

Weaver Knowles said the field of genetics is constantly changing and it can be to difficult to keep up on, especially for health care providers who already have a lot on their plate. That's why she's dedicated her career to educating other health care workers on the most up-to-date testing methods.

Weaver Knowles said she wishes she had known about genetic testing prior to getting diagnosed with breast cancer at age 38, four years after her sister died of the same. 

She underwent gene testing when she was diagnosed and learned that she carried BRCA1, a gene known to mutate and raise the risk of breast and/or ovarian cancer. Had Weaver Knowles known she had the gene earlier, she said she may have undergone a preventative mastectomy or have taken other measures, such as increased screenings, to decrease her risk of developing cancer or detect it earlier.

Weaver Knowles isn’t alone in advocating for genetic testing as a preventative measure for cancer. New federal guidelines also recommend that more women undergo breast cancer gene testing.

The new U.S. Services Preventive Task Force guidelines recommend that women who are survivors of breast or ovarian cancer, or who have a family history of cancer, should consider gene testing for hereditary cancer. Due to the guidelines, many of the simple saliva tests are covered by insurance as preventative health care.

Christie Fellows, a patient of Weaver Knowles, also underwent genetic testing in 2012 after she was diagnosed with breast cancer at age 37. Five years prior to her diagnosis, Fellows' two sisters underwent testing to see if it was hereditary, and when both of their results came back negative, Fellows decided to hold off.

"I didn't do it five years prior, and I wish that I had because I could have prevented myself from getting cancer had I done testing," Fellows said.

Fellows said that had she known she was a BRCA carrier, she would have had elective mastectomies.

"I could've done self-preservation for myself," she said. "I could've saved me from going through chemo and 10 surgeries and everything that went along with cancer."

Fellows is now six years out in remission but she still goes in to see Weaver Knowles every six months because she knows her genetics put her at high risk of developing cancer somewhere else in her body.

"I strongly recommend it to anyone that is questioning their health and to be proactive," Fellows said.

Weaver Knowles said she's working to educate more health care providers about panel testing, which tests for multiple genetic mutations associated with increased risk for eight different cancers, instead of the BRCA gene test that only identifies mutations in either one of the two breast cancer susceptibility genes — BRCA1 and BRCA2.

Weaver Knowles said this week, the panel testing helped one of her patients identify a genetic mutation for TP53, a gene that when mutated, is associated with breast, ovarian, colorectal, endometrial, melanoma, pancreatic, gastric, and prostate cancer, among other cancers.

"If I was testing for just BRCA 1 and 2, I would miss all of these other genes," Weaver Knowles said. "She doesn't have cancer yet, so that's powerful information for her."

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