Cancer and Angelina Jolie's Big Decision

Actress Angelina Jolie announced Tuesday in a New York Times op-ed piece that she recently underwent a double mastectomy to cut her chances of developing breast cancer after discovering she carries the "faulty" gene, BRCA1.

Jolie wrote she decided to receive genetic testing since she was at a higher risk of breast cancer — her mother fought the disease for almost a decade before dying at age 56 — and because she wanted to make sure she would be there for her children, according to her New York Times column.

Patch caught up with Selvi Palaniappan, MS, CGC Coordinator at Northside Hospital Hereditary Cancer Program, to learn more about these cancer genes.

P: What are the BRCA genes?

SP: They are two different genes called BRCA1 and BRCA2. Everybody has two copies of each of these genes (one from their mother and one from their father). So everyone has two copies of BRCA1 and two copies of BRCA2. The BRCA1 and BRCA2 gene are thought to be involved in DNA repair during cell division and regeneration. When you inherit a mutation in one of these genes you are at an increased risk for developing breast and/or ovarian cancer. Men who inherit a mutation in either of these genes are at an increased risk for prostate and/or male breast cancer.

P: What is the percentage of a woman developing breast cancer if she carries the BRCA1 or BRCA2 gene? What about ovarian cancer?

SP: If a woman inherits a mutation in either BRCA1 or BRCA2 your lifetime risk for developing breast cancer is up to 50-85 percent. The ovarian cancer risk depends on which gene has the mutation: the risk is higher if it is BRCA1 mutation – up to 40 percent lifetime risk. The BRCA2 mutation is associated with a lifetime risk of up to 20 percent. Remember that the general population risk for breast cancer is 12 percent and 1.5 percent for ovarian cancer. So a woman who inherits a mutation in either BRCA1 or BRCA2 has a much higher risk for developing breast and/or ovarian cancer, but not a 100 percent. There are many options for screening and prevention available for these cancers.

P: If a woman has a mastectomy or double mastectomy - does her risk of developing breast cancer decreases, by how much?

SP: If a woman who has inherited a mutation in the BRCA1 or BRCA2 gene has a bilateral or double mastectomy she will reduce her risk of developing breast cancer to less than 5 percent.

P: Tell us about BRCA testing?

SP: This testing is not recommended for the general population. It is recommended if you have had breast cancer at a young age or if you have had ovarian cancer at any age or if you have more than two family members with early onset breast and/or ovarian cancer on either your mother or your father’s side. It is always important to have an evaluation with a genetic counselor. A genetic counselor will take a detailed family history and evaluate whether there may be a hereditary component to the cancers in your family and guide you and your family through the genetic testing process. During the consultation the genetic counselor will discuss including detailed information about genetic test, how it affects you and your family as well as the options for screening and prevention. 

For more information about genetic testing or Northside Hospital’s Hereditary Cancer Program, call 404-851-6284 or visit the website.

What do you think about Jolie's decision and announcement? Let us know in the comments section.

Judy Davids and Amie Schaenzer contributed to this article.