Angelina Jolie’s mastectomy and gene testing article raises questions for women

Shereen Dindar
Contributing Writer
Shine On

Angelina Jolie made news Tuesday morning with a New York Times opinion piece explaining her reasons for getting a preventative double mastectomy.

She says she carries the BRCA1 gene which gives her a "87 per cent risk of breast cancer and a 50 per cent risk of ovarian cancer."

Jolie outlines that her mother, who died at age 56 due to cancer, was part of the impetus for the surgery.

"I can tell my children that they don’t need to fear they will lose me to breast cancer."

It is also Jolie's hope that by telling her story publicly, she will educate women on the fact that they can take preventative measures if necessary.

"Today it is possible to find out through a blood test whether you are highly susceptible to breast and ovarian cancer, and then take action."

But she is sure to mention, and even advocate against, the unfortunate inaccessibility of the genetic test due to its high cost in the U.S.

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"It has got to be a priority to ensure that more women can access gene testing and lifesaving preventive treatment...The cost of testing for BRCA1 and BRCA2, at more than $3,000 in the United States, remains an obstacle for many women."

After having finished three weeks of surgery on April 27, Jolie claims, "It does feel like a scene out of a science-fiction film."

While Jolie's message is certainly inspiring for those women who have similar genetic mutations and feel helpless, her article begs many questions for the average woman.

How important is it that all women get tested for this gene mutation? Can any Canadian woman get tested under provincial guidelines? Is it possible that surgery may not be the best choice for every woman with a gene mutation?

Firstly, according the the National Cancer Institute in the U.S., the average woman has a 12 per cent risk of getting breast cancer. Women with either the BRCA1 or BRCA2 mutation have about a 60 per cent chance of getting breast cancer.

A very small percentage of women, less than one per cent, actually carry a gene mutation that makes them more susceptible to breast cancer.

These mutations are most commonly found in Ashkenazi Jewish women, who carry an approximate 2.3 per cent chance of the mutations. Other ethnic groups, including the Norwegian, Dutch and Icelandic people, also have slightly higher rates of these mutations.

Also see: Husband documents wife's heroic battle with breast cancer

Canadian women who want to get tested need to be referred by their family doctor for genetic testing at a clinic or be approved by a genetic counsellor who looks at medical history to see if testing is necessary. Those who are deemed eligible will have the test covered by their provincial health insurance.

The reality is that only 3-7 per cent of breast cancer cases are linked to BRCA1 and BRCA2 genes. Couple this with the fact that the vast majority of breast cancer cases are tied to lifestyle factors, not genetic factors, and we've got a compelling case to look for other ways to prevent breast cancer in the general population.

"The majority of women considering their breast cancer risk should focus on things like a healthy lifestyle, eating a balanced diet, keeping a healthy weight and not drinking too much alcohol," Dr. Peter Johnson, chief clinician at Cancer Research U.K, tells CBC.

A diet high in fat, excess alcohol, and smoking are known risk factors for breast cancer.

With all of this information in mind, ladies, do you feel it is necessary for you to be tested for a BRCA1 and BRCA2 gene mutation?