It's been a little more than half a year since Angelina Jolie revealed that she's a carrier of the BRCA1 gene and had a preventative double mastectomy, but the "Angelina Jolie effect" can be felt stronger than ever, and it has some researchers all bent out of shape. Although Angelina's op-ed in the New York Times has encouraged more women than ever to seek genetic testing for the disease, the U.S. Preventative Services Task Force (USPSTF) says 9 out of 10 women should not receive the test.
Basically, this is just a loud reaffirmation of a 2005 recommendation that only a limited number of women with a family history of breast cancer be tested for mutations in the BRCA1 and BRCA2 genes that can increase their cancer risk. Even then, the women who do have a family history are supposed to discuss the test with both a family doctor and a genetic counselor before having the genetic test.
It's a bit aggravating because, surely, there are women who really could use the testing but are going to have to jump through even more hoops now thanks to the USPSTF's recommendation. (It bears noting that this is the same panel that has released controversial "recommendations" on women not receiving mammograms until they're 50 years old, which many doctors and women, including myself, think is nuts.)
But the panel's point where BRCA testing is concerned is that "only two or three women in a thousand have these mutations," so more testing is "not going to prevent most breast cancers." It's a valid point, and their bottom-line is a reasonable one: That women who are interested should be speaking with their doctors and genetic counselors about whether the test is right for them. (I'd assume most are doing that anyway, but okay, fine, it's a fair reminder.)
Ultimately, BRCA testing isn't necessarily for every woman. And if there's any silver lining in that, perhaps it's this: Focusing less on the genetic testing could mean turning our attention to many other factors besides our DNA that influence disease (such as stress, environmental toxins, lifestyle, nutrition, etc.), which we shouldn't be discounting or minimizing -- and that we can control.
Do you think only high-risk women should get genetic testing for breast cancer?
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