Breast Cancer, Genetics, and Angelina Jolie
I reassured most of my patients, specifically those at average risk, that the incidence of such a mutation is only about 1 in 400 or 500 in the general population. Certainly, that number can change based on individual risk, such as family history for breast or ovarian cancer, personal history of cancer, young age at diagnosis, etc. Even for my current patients with breast cancer, their risk of such a mutation is about 1 in 50. Basically, it’s really not a common finding among women.
However, Mary-Claire King, who was the lead geneticist in the discovery of the BRCA gene (the “breast cancer gene”), recently opined that all women over the age of 30 should be tested for the BRCA mutation. This is quite a bold statement, given that the test can cost between $3000-$4000. Insurance companies may cover the test, but usually only in cases where there is a strong indication to do so (i.e. personal and/or family history of breast cancer). I don’t think I’m ready to start ordering this test on every patient, given the low incidence of a positive result, but as genetic research evolves, we can more specifically define risk factors for patients and implement a more individualized approach to genetic testing. As usual, a measured and more thoughtful approach to genetic testing is best, in my opinion.
Christopher A. Menendez, M.D. F.A.C.S.
Breast Surgical Oncologist
Northwest Arkansas Breast Care Specialists
701 S Horsebarn Rd, Suite 100
Rogers, AR 72758
Phone: (479) 876-8028