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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.

22 September 2014 - by Jessica Ware 
The number of women in the UK being referred to breast cancer clinics doubled shortly after actress Angelina Jolie revealed she had a risk-reducing double mastectomy, a study has found....
7 April 2014 - by Baroness Delyth Morgan 
The news of Angelina Jolie's mastectomy last year brought breast cancer genetics, risk and prevention into the international spotlight. Her decision was only possible due to the efforts of researchers, over the past twenty years and more, to identify the inherited genetic mutations...
31 March 2014 - by Dr Sarah Spain 
BRCA1 mutations put carriers at high risk of cancer by failing to protect cells against the effects of high levels of oestrogen hormone found in breast and ovary tissue, researchers have established...
31 March 2014 - by Dr Caroline Dalton 
As we learn more, and as technologies develop, there are continuing challenges for the NHS to meet in providing the best possible care for people at risk of familial breast cancer...
2 December 2013 - by Dr Charlotte Warren-Gash 
Women from families with a history of carrying the cancer risk gene BRCA2, but who test negative for it, may be at higher risk of breast cancer than previously thought...
27 August 2013 - by Simon Hazelwood-Smith 
For the first time, a major health insurance company in the USA will require its customers to receive genetic counselling before it will pay for certain genetic tests...
28 May 2013 - by James Brooks 
A British man has had his prostate removed after testing positive for a mutation in the BRCA2 gene known to greatly increase the risk of cancer. The operation is thought to be the first prostatectomy performed due to an assessment of genetic risk...
28 May 2013 - by Chris Jacobs 
The news about Angelina Jolie opting for a double mastectomy to reduce her risk of breast cancer has undoubtedly raised concerns among women with a family history of the disease. Whilst this news has certainly raised awareness of hereditary cancer, there are two key points that it is important to emphasize...
28 May 2013 - by Dr Shanya Sivakumaran 
A genetic testing programme that will look for nearly 100 cancer risk genes has been launched, in the hope that genetic tests will become routine for cancer patients across the UK....
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