Relative Risk: Breast Cancer and Genetics
Progress Educational Trust
Darwin Lecture Theatre, Darwin Building, University College London, Malet Place, London WC1E 6BT
3 April 2014 - 6.30pm-8.30pm
An evening event organised by the Progress Educational Trust (PET) at University College London, supported by the Wellcome Trust and chaired by Dr Christine Patch, with speakers Kerry Andrew, Baroness Delyth Morgan and Professors Diana Eccles, Gareth Evans and Gordon Wishart.
When the actress Angelina Jolie wrote about her decision to undergo a double mastectomy, breast cancer captured the world's attention. Jolie opted for the procedure because of the breast cancer risk posed by a BRCA1 gene mutation she carries, and the fact that her mother and grandmother died from cancer. Jolie is still being widely praised for having promoted awareness and understanding of breast cancer, but her case raises two questions. First, to what extent was her situation representative - either of women in general, or of people who are predisposed to develop breast cancer? Second, to what extent was her response to her situation proportionate?
Breast cancer is a common form of cancer in women (and a rare form of cancer in men), but only a small minority of cases are thought to be caused by highly penetrant inherited mutations in a single gene. More than half of these cases are caused by mutations in the BRCA1 or BRCA2 genes, both of which also greatly increase the risk of ovarian cancer. BRCA genes aren't the whole story, however - nine non-BRCA genes linked to breast cancer are currently being tested for as part of the Mainstreaming Cancer Genetics programme, and an inherited predisposition to breast cancer may involve many genes rather than just one. Genetics may also affect people's responsiveness to breast cancer prevention and treatment, thereby opening up possibilities for tailoring prevention and treatment to individuals or groups (personalised medicine).
Counselling is available to women deciding what - if anything - to do if they are at increased risk of breast cancer. Mastectomy (removal of one or both breasts) and oophorectomy (removal of one or both ovaries) are two drastic preventative options, among several options that are available to patients in a similar predicament to Jolie. Among the less drastic options is one that was recommended recently by the National Institute for Health and Care Excellence - that healthy women over 35 at high risk of breast cancer should be offered preventative drug therapy, something that has not happened previously outside of clinical trials.
This event will see these and other aspects of breast cancer discussed in relation to genetics and risk, from contrasting perspectives, by a panel of experts. The event marks the launch of PET's 'Breast Cancer: Chances, Choices and Genetics' project, and will be followed by three further evening events at the same venue - 'Risk Assessment: Breast Cancer' on Thursday 8 May, 'Risk Management: Breast Cancer' on Thursday 5 June, and a concluding event on Thursday 3 July.