Why Some Women Choose Preventive Mastectomy

Angelina Jolie recently underwent preventive mastectomy, she revealed today in a New York Times op-ed piece. The actor/director underwent the procedure because the combination of a “faulty” BRCA1 gene and a family history of cancer put her at high risk of developing breast cancer or ovarian cancer.

Preventive mastectomy (also called prophylactic or risk-reducing mastectomy) is an operation that removes one or both breasts to prevent or reduce the chance of breast cancer for women at high risk for developing it. Preventive mastectomy may reduce the chance of developing breast cancer in moderate- and high-risk women by about 90 percent, according to the National Cancer Institute.

A family history of breast cancer and/or ovarian cancer is common in women diagnosed with breast or ovarian cancer, but inherited genetic mutations are associated with less than 10 percent of all breast cancers and less than 15 percent of ovarian cancers.

Most inherited genetic mutations are associated with the BRCA1 or BRCA2 genes. These mutations are inherited from one parent only, so it may affect several generations with breast and/or ovarian cancer. Women with the mutations have a markedly higher risk: Up to a 85 percent risk developing breast cancer and up to a 40 percent risk developing ovarian cancer. Men who carry BRCA1 or BRCA2 mutations are at increased risk of breast cancer and prostate cancer.

Arm Yourself with Information

Anyone who has a strong family history of breast or ovarian cancer or a relative with a BCRA1 or BCRA2 mutation may choose to undergo the test. Talk to a doctor first, and consult with a genetic counselor before and after testing.

Blood DNA tests for BRCA1 and BRCA2 mutations—ordered by a physician or genetic counselor–take about two weeks to return results. The test is not recommended for the general population, according to the American Association for Clinical Chemistry.

It is vital for young women to know about the importance of identifying family medical history, good breast health, and BRCA1 and BRCA2 mutations and everything they involve. Treatment of a “positive BRCA” test is a very personal choice, but knowledge empowers individuals to make their own well-informed decisions.

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