Today actress Angelina Jolie announced in the New York Times that she has undergone a preventive double-mastectomy to reduce her very high risk of developing breast cancer. Her mother died of breast cancer at age 56 and her maternal grandmother died at age 45, and she herself carries a defective BRCA1 gene. In her Times op-ed piece, Jolie describes the urgent need for all high-risk women to have access to the expensive BRCA test, “regardless of their means and background, wherever they live.” She also offers a candid description of the three-part surgical procedure she chose.
More importantly, Angelina Jolie has shared her very personal decision in order to help other women understand its emotional impact on a woman and her family. She describes the vital, supportive role of her partner, Brad Pitt, and her desire to assure their six children that “Everything else is just Mommy, the same as she always was. And they know that I love them and will do anything to be with them as long as I can.”
We applaud Ms. Jolie’s courage in sharing her story and her message to all women that being informed is empowering. Her final thought: “Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of.”
Read Angelina Jolie’s article “My Medical Choice.” What follows is a re-post of my December blog on BRCA genetic testing for breast or ovarian cancer.
Although most breast and ovarian cancers are sporadic—meaning they do not appear to be hereditary—women who carry genes known as BRCA1 and BRCA2 have a much greater risk of developing these cancers.
Should I be tested for the cancer genes? Your Ob-Gyn bases the decision whether to test on your family history of these cancers. Gene testing is beneficial for women who have twofirst-degree relatives (mother, daughter, or sister) diagnosed with breast cancer, if one was diagnosed before age 50. The blood test also benefits women with three first or second-degree (grandmother or aunt) family members who have had breast cancer, regardless of their age, and women who have both ovarian and breast cancer diagnoses among these relatives. (Click here for a more comprehensive description of risk groups). If your family history puts you in one of these groups, your physician may discuss with you the option of testing for the BRCA1 and BRCA2 genes.
Can anything else be done to detect these cancers early? Even if your gene test is negative, your physician may consider additional screening such as pelvic, ovarian ultrasound, a CA125 blood test, or breast MRI, depending on your age, medical and family history. And all women, regardless of their genetic history, should follow recommendations for screening mammograms. The American Congress of Obstetricians and Gynecologists recommends annual mammograms beginning at age 40. For women with a family history, your doctor may recommend a first mammogram before age 40.
IMPORTANT! At each annual exam, inform your OB-GYN of any changes in your family history.