Celebrities are in the news every day. Some receive accolades for their philanthropic contributions, and others are in the news for being admitted to a rehab facility. In 2013, Angelina Jolie released to the public news that she had undergone a double preventive mastectomy because of a maternal family history of breast cancer. The news was shocking to many, but it’s interesting to note that Jolie was not the first celebrity to have this procedure. Nearly five years ago, Christina Applegate had the surgery after testing positive for the BRCA gene at age 36. In 2012, Sharon Osbourne also opened up about her decision to have the preventive surgery.
Back to 1996
Genetic testing for the BRCA gene began in 1996. Since that time, we have seen more women choosing preventive mastectomies—an increase of 150% between 1998 and 2003, according to a news article from CNN that was released the same day that Jolie announced she had recently completed three months of procedures related to her double mastectomy and reconstructive surgery. Unfortunately, the awareness generated about BRCA 1 and BRCA 2 testing because of celebrity status has not been converted into increased knowledge among the population about what suspected mutations could mean for an individual.
According to a survey conducted by the University of Maryland School of Public Health and the Johns Hopkins School of Public Health, of 2,500 people surveyed, three-quarters knew Jolie’s story, but less than 10 percent could answer questions about mutations to the BRCA genes. Knowledge about what mutations to the BRCA genes can mean is the basis for understanding how that impacts an individual’s risk for the disease. For example, although a mutation in either BRCA 1 or 2 can mean an 87 percent increased risk of developing the disease, less than 1 percent of women have the mutation, and mutations in BRCA 1 or 2 account for no more than 5 to 10 percent of all breast cancer cases.
Just as celebrity fads in fashion might be appealing to the masses, I can see how a “success” story like Angelina Jolie’s might sway people to think that if the testing and surgeries were right for her, it could be right for them. However, one thing to consider is cost. Given that genetic testing is not widely covered by most health insurance, an individual is looking to spend nearly $3,000 out-of-pocket to be screened. With that in mind, the Centers for Disease Control and Prevention (CDC) recommends that before committing the money to testing an individual confirms a strong family history. Additionally, the CDC suggests, if possible, to have a living relative who has survived breast cancer be tested first to see if they carry one of the two harmful mutated genes, at which point the individual could determine if it would be beneficial for they themselves to be tested.
If there is an established history of breast cancer in your family, genetic testing might be the right option for you as you take an active role in the management of your health. However, if the history does not indicate an increased risk, don’t feel that you need to be tested just to “keep up with the Jolie’s”!