Breast Cancer Prevention: Jolie’s Awakening Move!
God has bestowed human beings with several emotions; be it happiness, pensiveness, jealousy, pride, hate, fear or love. The only strongest forces which can drive man to do the unpredictable and capricious things in impulsiveness than anything in the world! And these very forces prove the strongest when it comes to one’s own “self”. Hence, in an attempt to safeguard oneself man will go beyond the limits the mind can think. A natural phenomenon keeping mankind alive so far!
Scrolling down my twitter blogs my eye brows raised at a similar brave act of safeguarding oneself irrespective of other’s opinions that was the news of Angelina Jolie getting a prophylactic double mastectomy done to prevent the risk of breast cancer but why making it public was my next thought! Later I discovered that she wanted to inform women with a history of breast cancer in their families about the need to seek out testing and counseling through her example how she bravely dealt with the high risk of getting breast cancer. Angelina Jolie has done a real service for women around the world like always by making her decision public.
She got her genetic testing for vulnerability to breast cancer and then, when the results came back positive, she decided to go for a double mastectomy. For a woman whose career is tied to her appearance, her compliance to talk about her decision provides support to women and their partners who may face a similar difficult choice. But the question is before taking such a bold step can we be sure of the effectiveness of the procedure. Well, talking about a research published in Journal of Clinical Oncology in 2004:
“Bilateral prophylactic mastectomy reduces the risk of breast cancer in women with BRCA1/2 mutations by approximately 90%.”
So it actually helps you if you get it screened at an early time. Further supported by evidence of two studies emphasized in TIMES health section, conducted in 2010 and 2011 also reflected that the survival rate and the risks of not developing breast cancer after the mastectomy, oopherectomy and ovaries removed were up to 80-90%. Since the person with BRCA mutations is not only at risk of developing breast cancer but also ovarian cancer like Angelina’s mother who died in her late 50’s due to the very same gene.
But the genetic test for the BRCA mutations isn’t done for every woman, or even for every woman who is at risk of developing breast cancer. Doctors recommend it for those who develop cancer at a young age, or have multiple family members with the disease. It’s expensive – up to $3000 – and insurers require that patients meet a threshold for needing the test before they cover its cost. Even such high costs would be worth paying only if the tests sensitivity is assured.
Not necessarily the BRCA mutation’s positive history comes out to be positive always in the tests, there is still high risk of developing the cancer even when the test is negative since there are variable mutational changes going on and other genes are also involved for causing the disease, as according to a study in JAMA (2006). “The mutational spectra of BRCA1 and BRCA2 include many high-penetrance, individually rare genomic rearrangements. Among patients with breast cancer and severe family histories of cancer who test negative (wild type) for BRCA1 and BRCA2, approximately 12% can be expected to carry a large genomic deletion or duplication in one of these genes, and approximately 5% can be expected to carry a mutation in CHEK2 or TP53. Effective methods for identifying these mutations should be made available to women at high risk.”
Jolie is fortunate to be able to afford not just the test but the reconstructive surgery following the procedure as well. But her heroic act left us with considerations for making the health care system not only curative but better diagnostic/preventive and making women aware of the possible options they have to make their lives better and longer.
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