"The Angelina Jolie Effect"

Dr. Dori Kasparek

The news that Angelina Jolie made the hard choice to undergo a bilateral or "double" mastectomy to reduce her chances of developing breast cancer may sound shocking to you.  But when you consider that her chances of getting it go from nearly 87% to about 5% during her lifetime, you can see why she made that decision.

Breast cancer effects approximately 250,000 individuals every year and at any given point in time there are almost 2.9 million persons surviving with breast cancer.  Every year, nearly 40,000 will die from breast cancer making it the second leading cause of death from cancer in the United States (lung is first).

Angelina Jolie's situation is extreme because she carries the BRCA genetic mutation that places her at extremely high risk.  She has a 9 out of 10 chance in her lifetime that she is going to get breast cancer as compared to those without the mutation in the general public, the lifetime risk ranges around 1 out of 9 chances.  The presence of the mutation is responsible for only about 5% of breast cancers that develop.  Seventy five percent of breast cancers are diagnosed in women without any known risk factors.

What does that mean for you?

First, know the risk factors.  Here is a list of the most common ones.

  1.  early onset of menarche = having your first period before age 12
  2. late onset of menopause = having your last cycle over age 55
  3. late age of having first child = older than 30 when first child is born
  4. age
  5. race
  6. ethnicity, especially Ashkenazi jewish
  7. smoking
  8. obesity
  9. family history of direct relative with breast cancer
  10. recent OCP use
  11. alcohol intake of 2 or more drinks a day
  12. hormone replacement therapy in menopause especially above age 60
  13. BRCA 1 or BRCA 2 mutation positivity

This is by no means a comprehensive list.  And even if you have several risk factors it does not mean you will get breast cancer.

There are also factors that can reduce your risk of developing breast cancer such as breast feeding, low fat diet, and exercise.

The recommendation for the general population for breast health is to minimize risk factors, participate in routine self breast examinations monthly, as well as clinical breast exams yearly by appropriate medical personal, and have a mammogram yearly starting at age 40.

In those with direct family member such as a parent, child or sibling diagnosed with breast cancer or with multiple relatives such as aunts/uncles or cousins that have been diagnosed with breast cancer talk with your doctor to see if you are a candidate for BRCA 1/2 testing. Your primary care or gynecologist can order this test for you if criteria is met. It is a simple blood draw that may change not only your life but your family's too.

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