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Trenton — Sunday will be a special Mother’s Day for Max Koehn.

While his mom is recovering from aggressive chemotherapy, radiation and surgeries, she’ll still be able to play on the floor with him and his toy trucks.

His grandmother, Dawn Stewart, makes a point of their special bond, “His good night to her every night is: ‘Love you so much, moon and stars. You’re my best girl.’ ”

Max is 3 years old. He was only 20 months old when his mom, Melissa Koehn of Trenton, heard life-altering words from her doctor over the phone: “You have breast cancer.”

She was only 32 years old. She exercised, ate healthily and did not smoke.

The words heard on June 22, 2016, were terrifying, she said. She repeated them to her husband, Steve, who called off from work that day. But it was only the beginning of a journey that resulted in both mom and grandmother undergoing mastectomies and hysterectomies.

It was a decision made after both tested positive for the BRCA1 and BRCA2 genes. A woman’s lifetime risk of developing breast and/or ovarian cancer is increased if she has a harmful mutation in these genes, according to the National Cancer Institute.

While the mastectomy was necessary, Koehn opted also to undergo the hysterectomy. Stewart, 60, who did not have cancer, chose to have both risk-reducing surgeries.

“I’m totally glad I did it and would not go back and change it ever,” said Koehn, now 34, who said she still feels weak from the effects of chemotherapy. “I am a strong advocate for getting tested.”

Stewart, who said she moved to Trenton to be closer to her daughter, chose to have the surgeries as a prophylactic measure.

But did she hesitate?

“Not for a minute,” she said. “I had been working on getting tested when Melissa was diagnosed. I definitely wanted to be tested and only wish I had done it sooner.”

The risk-reducing surgeries are not 100 percent saviors.

“Research has demonstrated that risk-reducing surgery results in a longer and healthier disease-free life for those individuals with a known BRCA1 or BRCA2 mutation, thus national guidelines were established that risk-reducing surgery be offered to known carriers of BRCA mutations,” said Dr. Julie Zenger-Hain, director of Cytogenetics at Beaumont Hospital in Dearborn, who counseled the family, in an email response to questions.

“It is important to note, however, the risk of cancer is not eliminated with risk-reducing surgery.”

According to the National Cancer Institute, the gene mutation can be inherited from a person’s mother or father. Each child of a parent who carries a mutation in one of these genes — BRCA1 or BRCA2 — has a 50 percent chance of inheriting the mutation. About 12 percent of women in the general population will develop breast cancer.

The cancer institute says by contrast, about 72 percent of women who inherit the BRCA1 mutation and about 69 percent who inherit a BRCA2 mutation will develop breast cancer by the age of 80.

About 1.3 percent of women in the general population will develop ovarian cancer during their lives, while about 44 percent of women who inherit a BRCA1 mutation and about 17 percent who inherit a BRCA2 mutation will develop ovarian cancer by the age of 80.

Stewart recommended other family members get tested for the gene mutation.

“After Melissa and I were tested, my daughter, Andrea, waited to deliver twin girls before testing,” she said. “Andrea ended up testing negative, something we are all grateful for. My sister was tested and ... did test positive as well.”

But before pursuing genetic testing, Zenger-Hain offers some guidelines.

“Genetic testing can be performed in anyone, however many national networks/professional specialist groups have established criteria as to who are the best candidates for genetic testing to enhance the likelihood of identifying individuals with genetic changes (mutations) who can then in turn benefit the most from early detection and prevention options,” Zenger-Hain said.

She also said those who should seek genetics counseling include women with breast cancer diagnosed before 50, those with cancer in both breasts, with ovarian cancer at any age, women with both breast and ovarian cancers in either the same woman or the same family, multiple breast cancers in the family and men with breast cancer.

Stewart said nine members of her extended family had cancer diagnoses, including both of her parents.

Today, Koehn said she feels, “OK.”

“I have good and bad days, and I’m still pretty weak,” she said. “I have a few other health concerns, but I feel pretty good.”

Even when she was so sick she had to remain in bed for five days following the chemo treatments, she rallied enough to play with Max, she said.

“I’m just happy to be able to be a mother,” she said. “I’m grateful for every day I’m here. I have the loving support of my wonderful mother. We make a good team.”

Asked how this Mother’s Day will be different, Stewart responded, “I am so grateful that we are all still here together. I have witnessed the strength, courage and fortitude of my beautiful daughter.

“Through all the trials and suffering, Melissa’s attention and devotion to Max has been unwavering. She is truly an amazing mother and woman. I am so proud of her and love her more than words can ever express.”

SLewis@detroitnews.com

(313) 222-2296

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