Angelina’s BRCA Gene, Her Decision and What it Means for You
By Dr. Jaime Arruda
In mid-March 2015, 39-year-old actress Angelina Jolie voluntarily had surgery to remove her ovaries and Fallopian tubes. Two years prior, she had a double mastectomy, removing all of her breast tissue. The question is Why?
Because Angelina has a mutation of the BRCA gene, which dramatically increased her chances of getting breast cancer (87 percent) and ovarian cancer (50 percent), as well as other cancers. BRCA1 and BRCA2 genes produce tumor-suppressing proteins. These proteins help to repair damaged DNA, which prevent the cells from developing more abnormalities that can lead to cancer.
Specific mutations of the BRCA genes compromises someone’s ability to produce tumor-suppressing proteins, predisposing women to breast and ovarian cancer. Facing that reality, Angelina made a decision: Without breasts or ovaries she is at a much lower risk, close to 0 risk, for breast or ovarian cancer.
However, her three biologic children may have the same BRCA mutation, because each have a 50 percent chance of inheriting it from their mother. So Angelina’s worries are not completely over. All this brings up another question:
What can other women learn from Angelina’s example?
Her short answer is to talk to your doctor.
“A positive BRCA test does not mean a leap to surgery,” Angelina wrote in a New York Times op-ed about her most recent surgery, “I have spoken to many doctors, surgeons and naturopaths. There are other options… There is more than one way to deal with any health issue. The most important thing is to learn about the options [from your doctor] and choose what is right for you personally.”
This is excellent advice, because in troubling medical situations such as this, it is good to talk things through. With yourself, your loved ones, and your physicians who have the facts and are experienced in dealing with these life-altering issues. Talking it through helps greatly, no matter what your final decision is.
People should consider genetic testing for a BRCA mutation if they know that a family member has a mutation or if breast and ovarian cancer are prevalent in the family tree. If a person tests positive for a BRCA gene mutation, there are many options to prevent and reduce chances of developing breast or ovarian cancer.
BRCA, IVF and PGD
Many individuals with BRCA mutations choose to undergo in vitro fertilization (IVF) with pre-implantation genetic (PGD) testing in order to ensure that their children do not have the gene mutation of BRCA. PGD ensures that only embryos free of genetic defects are implanted in the womb for pregnancy.
Other Ways to Reduce Your Risk of Breast Cancer
While a double mastectomy and the removal of the ovaries and fallopian tubes is a viable option, it is not the right option for everyone. Other options for prevention and monitoring of breast and ovarian cancer include birth control medication and the removal of the fallopian tubes., Hormones commonly found in birth control, have been found to affect the growth and development of some tumors.
Contrary to popular belief, use of birth control for more than 10 years actually reduces the risk of ovarian cancer, and use of birth control pills for treatment in premenopausal woman carries no change in breast cancer risk.
Some women with the BRCA mutations may still want to have children naturally. After all, having the mutation is no guarantee that it will result in cancer or be passed on to offspring. It comes down to the individual’s preference and attitudes.
Angelina’s mother, aunt and grandmother all died from cancer and she did not want that same fate. Having the BRCA gene mutation made that much more likely for Angelina.
She made an informed decision, “I know my children will never have to say, ‘Mom died of ovarian cancer.’”
That move by a famous and popular actress has set a good example for all women: when in doubt, talk to your doctor. Doing that can give immeasurable peace of mind that the decision you ultimately choose will be the best one for you.