Angelina Jolie and Prophylactic Bilateral Mastectomies

Angelina Jolie got a lot of publicity when she came public recently about undergoing prophylactic bilateral mastectomies. She had undergone genetic testing and was found to be positive for the BRCA1 gene. Many women are now questioning whether they should undergo genetic testing for this muation. The answer for most women is, “No”. In Angelina’s case, her mother was diagnosed with ovarian cancer, and her mother’s sister with breast cancer (in fact her aunt just died of her breast cancer recently). With this combo of breast and ovarian cancer in sisters, there was a high enough possibility of finding a mutation, that genetic testing was appropriate. I do not know whether her sister or aunt were tested before she was, but usually, someone WITH breast or ovarian cancer is tested first in the family.

Only about 5% of women diagnosed with breast cancer carry one of the BRCA mutations. And in most of these cases, there is a fairly strong family history of cancer, to raise suspicion. At DeKalb Surgical, patients who need referral for genetic testing are sent to the Cancer Center conveniently located in the same building as our office. We have excellent resources for providing the appropriate counseling, and test results can be obtained in 2-3 weeks. Patients who might be considered for genetic testing include: newly diagnosed breast cancer at an early age, “triple negative breast cancer”, recurrent or bilateral breast cancer, men with breast cancer, 2 or more first degree relatives with breast and/or ovarian cancer, or a strong family history of a variety of cancers.

There are some other cancers which raise suspicion for other genetic mutations, such as certain colon cancers, some skin cancers, and certain unusual thyroid cancers. But for most of you readers, genetic testing for cancer risk is not indicated or necessary. But there are a number of things you can do in general to decrease your risk of ever developing breast or other cancers, including smoking cessation, weight reduction for those above ideal body weight, regular exercise, stress reduction, and screening tests, including, when appropriate, mammography, Pap smears, colonoscopy, and skin checks. Nutrition is also very important. You may want to check out the book “Anti-Cancer” as one very good resource.