Ever since the much-publicised double mastectomy by the famous Hollywood star in May 2013, there has been quite a bit of confusion by women as to whether removing both breasts surgically is the only answer to avoid getting breast cancer. Even today, my colleagues are still being asked this question frequently.
Here are some facts regarding this:
- Most breast cancers (90%) are not inherited.
- The inherited form, due to alteration in the BRCA genes, account for 5-10% of cases.
- Routine screening by BRCA testing is not recommended. The blood test is expensive, costing anywhere between USD 1000-4000 and takes about three weeks before results are known.
- BRCA testing is usually done where there is a related history of breast cancer. Indeed, there are specific indications for doing this test, e.g for women with two first-degree relatives with breast cancer below 50. For a full list of indications, see here.
This graph shows how the risk of cancer is much higher in those tested positive for BRCA.
What happens if the BRCA test is positive? As such people have a very high chance of getting cancer of the ovaries and breasts, there are a few options available. It does not necessarily mean that double mastectomy is the only way out. Other options include taking medications, more intensive and regular breast cancer screening and having both ovaries removed before the age of 40. The right decision involves the patient being fully informed and playing an active role in the decision-making process.
Whatever the decision, its important to execute it immediately as procrastination is the worst enemy. Jolie’s case highlights the importance of knowing one’s family history and learning one’s cancer risks in order to address them proactively.
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