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The Jolie effect: breast cancer gene testing increases, but so do surgery requests

7 October 2013
Appeared in BioNews 725

A London clinic has reported an increase in the number of requests for BRCA genetic testing and preventative mastectomies since Angelina Jolie's announcement last May that she had undergone a double mastectomy.

The actress chose to have a double mastectomy after learning she was a carrier of a mutation in the BRCA1 gene, which indicated an increased risk of developing breast cancer. However, some doctors have reported seeing requests from patients to have a double mastectomy even when a high risk of developing the disease is not indicated.

Professor Kefah Mokbel, lead breast surgeon at the private London Breast Institute, said: 'It's obviously a great step forward that Angelina Jolie has increased awareness of breast cancer'.

'But we're seeing a large number of women requesting a preventative mastectomy for peace of mind, women who've been diagnosed but don't have a genetic predisposition so wouldn't benefit. These are patients who say, "Can you do for me what Angelina Jolie had done?" They're on the increase'.

Preventative or prophylactic mastectomies, carried out on non-cancerous breasts to reduce the risk of cancer developing, have been shown to be around 90 percent effective at reducing the occurrence of breast cancer in women but are only recommended if a patient is at very high risk of developing the disease. Less extensive surgical procedures and non-surgical alternatives are available for those in lower risk groups.

Jolie tested positive a mutation on the BRCA1 gene, which indicated an increased risk of breast cancer by more than 80 percent and an increased risk of ovarian cancer by 50 percent. However, less than one percent of women carry faulty versions of the BRCA1 and BRCA2 genes combined and only women with family histories of breast cancer are encouraged to have genetic testing done.

Together, BRCA1 and BRCA2 mutations account for about 20 to 25 percent of hereditary breast cancers and around five to ten percent of all breast cancers. Other genes have also been linked to breast cancer risk.

The London Breast Institute, based in The Princess Grace Hospital, explains that the risk of breast cancer in women is also influenced by the location of the genetic fault, the use of the contraceptive pill and also lifestyle factors.

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