Angelina Jolie’s Preventative Surgery Sparks “The Angelina Effect”

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Ever since Angelina Jolie revealed that she had a preventative double mastectomy last May, many women are considering getting tested for the BRCA gene to find out if they, too, are carriers in what is being called the “Angelina Effect.” Though her publicized decision post-surgery raised awareness in many, it also generated much confusion.

Soon after learning that she carried the BRCA1 gene—a mutation that puts a person at higher risk for some cancers—Jolie decided to have preventative surgery. In a New York Times op-ed, Jolie wrote, “I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer. It is my hope that they, too, will be able to get gene tested, and that if they have a high risk they, too, will know that they have strong options.”

It is good for women to become well-educated about their health but, according to the U.S. Preventative Services Task Force, unnecessary BRCA testing can potentially cause harm to those being tested without biological history of the disease. A few days ago, the organization announced, “The USPSTF recommends against routine genetic counseling or BRCA testing for women whose family history is not associated with an increased risk for mutations in the BRCA1 or BRCA2 genes.”

As for Jolie, her family has a strong history of breast cancer that she was aware of before undergoing genetic testing. In addition, in her op-ed she wrote that a “faulty” gene had been found. Combined with her family history, she had an 87% risk of developing breast cancer.

“There is a very clear-cut algorithm for whether or not to test someone for a BRCA mutation,” said Dr. Jennifer Ashton, a senior medical contributor to ABC News and practicing OB-GYN. “Simply having breast cancer in the family is not sufficient.” Additionally, the panel agrees that only women who have a history of breast cancer in their family should be screened to determine if they need genetic counseling. Only if the genetic counselor says that genetic testing for the BRCA gene is necessary should it be considered.

What many people are not aware of is that the BRCA genetic mutation is quite rare. Dina L.G. Borzekowski, a professor of behavioral and community health, told The New York Daily News that, in the general population, “one in 300 to one in 500 women have [the mutations]. I think people were also not understanding that breast cancer is relatively common, and that the mutation only contributes to some of the cases that are out there.”

According to the Mayo Clinic, BRCA mutations are “uncommon” and are responsible for “about 5 percent of breast cancers and about 10 to 15 percent of ovarian cancers.” According to the National Cancer Institute, 12 perfect of women in the general population will develop breast cancer—of those women, 55 to 65 percent will have the BRCA1 mutation while 45 percent of will have the BRCA2 mutation.

Though genetic testing has a moderate benefit for the women who fit the criteria and are BRCA positive, the testing can be harmful to the majority of the population, adds the panel.

“Intensive screening for breast and ovarian cancer is associated with false-positive results, unnecessary imaging and unneeded surgery,” wrote the panel in the announcement released earlier this week. For example, a drug that reduces the risk of breast cancer has been associated with an increased risk of blood clots.

Unfortunately, many people heard about Jolie’s procedure through second-hand—and even third-hand—sources, and were not given the necessary details in order to understand why she had the double mastectomy.

Borzekowski adds that she “really felt that [Jolie] did something very courageous and remarkable. Celebrities can do a great job in raising awareness about different diseases or illnesses, and she did that. The problem is, she was talking about something very difficult [that] people have a hard time understanding.”

 

 

Do you think that women should get tested even if they don’t have a history of breast cancer in their family?

 

 

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