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'Angelina Effect' on breast cancer genetic screening

Tuesday, September 02, 2014

In the first study in a Canadian setting, Sunnybrook researchers report a 90% increase for women referred for breast cancer genetic counselling following actress Angelina Jolie’s announcement that she had undergone a preventive double mastectomy after testing positive for the BRCA1 gene mutation, but note similar proportions of women referred before or after the news were at very high genetic risk. The study was presented at the 2014 ASCO (American Society of Clinical Oncology) Breast Cancer Symposium.

BRCA1 or BRCA2 gene mutations are linked to hereditary breast and ovarian cancer. Everyone has BRCA1 and BRCA2 genes, known as tumor suppressor genes that make proteins to repair DNA, and suppress the growth of cancer. A mutation of the BRCA gene means that DNA damage cannot be repaired as well, which increases the risk for cancer.

"At our own cancer centre, we were encouraged by Ms. Jolie's courageous story which seemed to have a significant and meaningful influence on health care providers and the public about awareness for breast cancer genetic screening and preventive options,” says Dr. Jacques Raphael, breast oncology research fellow and lead author, who conducted the study under the supervision of Dr. Andrea Eisen, medical oncologist and head, Preventive Oncology of the Breast Cancer Care team at Sunnybrook’s Odette Cancer Centre in Toronto, Canada.

Dr. Raphael reviewed the number of women referred for genetic counselling at the Odette Cancer Centre's Familial Cancer Program, and compared rates six months before and after the release of Angelina Jolie’s story in May 2013.

"Among the larger number of women we saw for genetic counselling after the news, the proportion of women determined to be high risk, like Ms. Jolie, was about the same as the proportion seen before the news, suggesting that we continue to see many of the women who need screening most," says Dr. Andrea Eisen.

Angelina Jolie

Full media release

‘THE ANGELINA EFFECT’ ON GENETIC SCREENING FOR BREAST CANCER: First study in a Canadian setting reports anticipated surge in women referred for genetic counseling, but with similar proportions of women at increased risk, being seen before the news and after.

In the first study in a Canadian setting, Sunnybrook researchers report a 90% increase for women referred for breast cancer genetic counselling following actress Angelina Jolie’s announcement that she had undergone a preventive double mastectomy after testing positive for the BRCA1 gene mutation, but note similar proportions of women referred before or after the news were at very high genetic risk. The study was presented at the 2014 ASCO (American Society of Clinical Oncology) Breast Cancer Symposium.

BRCA1 or BRCA2 gene mutations are linked to hereditary breast and ovarian cancer. Everyone has BRCA1 and BRCA2 genes, known as tumor suppressor genes that make proteins to repair DNA, and suppress the growth of cancer. A mutation of the BRCA gene means that DNA damage cannot be repaired as well, which increases the risk for cancer.

"At our own cancer centre, we were encouraged by Ms. Jolie's courageous story which seemed to have a significant and meaningful influence on health care providers and the public about awareness for breast cancer genetic screening and preventive options,” says Dr. Jacques Raphael, breast oncology research fellow and lead author, who conducted the study under the supervision of Dr. Andrea Eisen, medical oncologist and head, Preventive Oncology of the Breast Cancer Care team at Sunnybrook’s Odette Cancer Centre in Toronto, Canada.

Dr. Raphael reviewed the number of women referred for genetic counselling at the Odette Cancer Centre’s Familial Cancer Program, and compared rates six months before and after the release of Angelina Jolie’s story in May 2013.

"Among the larger number of women we saw for genetic counselling after the news, the proportion of women determined to be high risk, like Ms. Jolie, was about the same as the proportion seen before the news, suggesting that we continue to see many of the women who need screening most," says Dr. Andrea Eisen.

The study found 916 women were referred for genetic counselling after her announcement, compared to 487 women prior, or an increase by 90%. 437 women in this group representing an increase of 105% (compared to 213 prior) were considered high risk (defined by the Ontario Ministry of Health and Long-Term Care) and qualified for genetic testing.

Similar proportions of 25 and 28%, or 121 of the 487 women referred before the news, and 264 of the 916 women referred after the news, were at very high risk.

The number of women identified with a BRCA gene mutation increased by 110%, or 29 before, and 61 after.

Genetic counseling involves screening, individual counselling and cancer risk discussions, testing and discussions about potential preventive surgical options. Specifically for BRCA gene mutation testing, individuals find out whether they have an inherited BRCA gene mutation, receive counselling and an assessment of their personal risk for breast cancer and or ovarian cancer, and discuss with genetic counsellors, management options including preventive (prophylactic) surgeries.

BRCA1 and BRCA2 gene mutations are linked to up to half of hereditary breast cancers, about 5 to10 percent of all breast cancers, and about 15 percent of all ovarian cancers.

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For more information, please contact:

Natalie Chung-Sayers, 416.480-4040, natalie.chung-sayers@sunnybrook.ca

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