Writing in the New York Times on Tuesday, actress Angelina Jolie explained why she underwent a preventive double mastectomy earlier this year after discovering she had the BRCA1 gene—and why other women should get tested and "take action."
Jolie writes that her mother died of cancer at age 56 after spending nearly a decade battling the disease. Her children "have asked if the same could happen to me," she writes. According to Jolie, the BRCA1 gene increases the average person's risk of developing cancer by 65%. Her doctors estimated she had an 87% risk of developing breast cancer and a 50% risk of developing ovarian cancer.
"Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much as I could," Jolie writes. She details the three-month process of undergoing a double mastectomy, beginning with a "nipple delay" procedure on Feb. 2 and ending with the breast reconstruction and implants on April 27.
"I am writing about it now because I hope that other women can benefit from my experience," Jolie writes, adding that "I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer."
She encourages women—especially those with a family history of cancer—to seek out medical advice and make informed choices, adding that giving more women access to gene testing needs to be "a priority."
"The cost of testing for BRCA1 and BRCA2, at more than $3,000 in the United States, remains an obstacle for many women," Jolie writes. She notes that most of the 458,000 lives claimed by breast cancer each year are in "low- and middle-income countries."
Jolie also writes that, "[o]n a personal note, I do not feel any less of a woman." She emphasizes the importance of support from family. "[T]o anyone who has a wife or girlfriend going through this, know that you are a very important part of the transition," she writes.
In the end, Jolie says that her decision feels right because she can tell her children "that they don't need to fear they will lose me to breast cancer" (Jolie, Times, 5/14).
The economics of BRCA testing
BRCA testing could improve outcomes and lower costs. So why aren't more providers performing it more often?
The Oncology Roundtable's Lindsay Conway weighs in on the economics of BRCA testing, with a special review of the financial and care delivery barriers preventing the test's broader adoption.