Angelina Jolie’s Choice: Should You Get BRCA Gene Testing?

iStockphoto/Thinkstock(NEW YORK) — Angelina Jolie’s decision to get tested for gene mutations linked to a heightened breast cancer risk has many women wondering whether they should get tested, too.

Women with mutations in the genes BRCA1 or BRCA2 are five times more likely to be diagnosed with breast cancer, according to Cancer.gov.  That means that 60 percent of women with a BRCA mutation will develop breast cancer in their lifetime, compared to 12 percent of women in the general population.

But less than 1 percent of women actually have a BRCA mutation, making costly genetic testing unnecessary for most.  Could you be one of them?  You can learn a lot from your family history.

For women who are not of Ashkenazi Jewish descent, Cancer.gov recommends genetic testing if you have:

• Two first-degree relatives diagnosed with breast cancer, with one of them before age 51. First-degree relatives include your mother or sister;
• Three or more first- or second-degree relatives diagnosed with breast cancer. Second-degree relatives include your grandmother or aunt;
• A combination of first- and second-degree relatives diagnosed with breast cancer or ovarian cancer;
• A first-degree relative diagnosed with cancer in both breasts;
• A combination of first- or second-degree relatives diagnosed with ovarian cancer;
• A first- or second-degree relative diagnosed with breast and ovarian cancer;
• A male relative diagnosed with breast cancer.

For women of Ashkenazi Jewish descent, who are more likely to carry a specific BRCA2 defect passed from generation to generation, Cancer.gov recommends genetic testing if you have:

• A first-degree relative diagnosed with breast or ovarian cancer;
• Two second-degree relatives on the same side of the family diagnosed with breast or ovarian cancer.

About 2 percent of adult women have a family history pattern described above but, again, less than 1 percent of women will have a BRCA mutation.

“Not every woman in such families carries a harmful BRCA1 or BRCA2 mutation, and not every cancer in such families is linked to a harmful mutation in one of these genes,” according to Cancer.gov.  “Furthermore, not every woman who has a harmful BRCA1 or BRCA2 mutation will develop breast and/or ovarian cancer.”

Women without one of the family history patterns described above are unlikely to have a harmful BRCA mutation, according to Cancer.gov.

Based on her genetic testing results, Jolie opted for a preventive double mastectomy — the surgical removal of both breasts to reduce the risk of breast cancer.  

Studies suggest that preventive mastectomy can reduce breast cancer risk by about 90 percent in high-risk women, according to Cancer.gov.  But surgery carries risks, too, so women are advised to talk to their doctors about the procedure’s pros, cons and possible alternatives.

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