RSS Feed
May 15th, 2013 
Peter Nolan
Updated
Doctors are predicting an increase in the number of Australian women getting tests for breast cancer gene mutations, after Angelina Jolie’s revelation she underwent a double mastectomy.
The Oscar-winning actress has revealed she had the operation after discovering she carried the BRCA1 gene mutation, giving her an 87 per cent chance of developing breast cancer.
Dr Allan Spigelman, clinical director at the Kinghorn Cancer Centre in Sydney, expects the superstar’s comments to spark interest in cancer gene testing in Australia.
“I fully anticipate there will be very significantly renewed interest in breast cancer gene testing across the world as a result of this high-profile person very sadly carrying the gene change but very bravely going ahead to have preventative surgery,” he said.
Both the BRCA1 and BRCA2 mutations can greatly increase a woman’s risk of developing breast and ovarian cancer.
Dr Spiegelman says there are a number of factors that can put a woman in the high risk category.
“The age of onset of these cancers, the number of people in their family with these cancers and also to a degree what some of the cancers look like under the microscope,” he said.
BRCA1 and BRCA2 genes
BRCA1and BRCA2 are genes linked to hereditary breast and ovarian cancer
They help repair breaks in DNA, so faulty genes mean DNA repair is not optimal
The risk of a woman with the gene developing breast cancer is between 40 and 65 per cent
Tests for genes are done through a blood sample
In Australia tests cost $2000 – $2500
Tests can be cheaper – or free – if genes are detected in family members
About 5 per cent of breast cancers are hereditary and may involve the genes
“When you compute all of that you can come out with a probability of carrying a gene change.”
He says these criteria are used to determine if a woman should undergo testing for the BRCA1 and BRCA2 gene mutations.
“It’s quite a generous criteria in a sense if one has a 10 per cent or greater chance of having a gene change found in one of those two genes then publicly-funded gene testing for breast cancer is available,” he said.
Dr Spigelman says out of every 100 women with breast cancer, the BRCA1 and BRCA2 gene mutations affect about five of them.
Still, he says only a minority of women in Australia found to be carrying the gene mutations choose to have a double mastectomy.
Dr Spigelman says it can be hard for women to access plastic surgeons for reconstruction surgery following a mastectomy.
“Where we’re limited is with access often to public plastic surgeons for the reconstruction component,” he said.
“However, the system that’s established in much of Australia, when women are tested involves attending a hereditary cancer clinic.
“Those clinics by and large have good relations with local breast surgeons and plastic surgeons so if a woman is unable to afford the procedures or is not covered by her private insurance, then we can help that woman navigate the health system so they can have the treatment of their choice.”
‘Bold’ Jolie
Jolie’s doctor, meanwhile, has hailed her “bold” and positive attitude as she underwent three operations to remove tissue and reconstruct her breasts in February and April.
“To a large extent, I believe recovery reflects expectation. Angelina expected to feel well, to be active,” Dr Kristi Funk wrote in a blog posted by the Pink Lotus Breast Center in Beverly Hills.
She says Brad Pitt, with whom Jolie has six children, attended for all three operations, starting on February 2 with a procedure which lessens the risk of losing the nipples.
“Her partner was on hand to greet her as soon as she came around from the anaesthetic, as he was during each of the operations,” Dr Funk said.
The main surgery was on Saturday, February 16, and “went smoothly,” she wrote.
Two days later, there was good news.
“The pathology returned and I called Angelina to confirm our biggest hope: all of the breast tissue was benign,” Dr Funk wrote.
I believe recovery reflects expectation. Angelina expected to feel well, to be active.
“On day four after her mastectomies, I was pleased to find her not only in good spirits with bountiful energy, but with two walls in her house covered with freshly assembled storyboards for the next project she is directing.”
“All the while she spoke, six (surgical) drains dangled from her chest, three on each side, fastened to an elastic belt around her waist.”
Dr Funk says the final operation was carried out on April 27, ten weeks after the mastectomies, reconstructing the breasts with implants, “which went extremely well, bringing an end to her surgical journey”.
For Australian woman Heidi, having a double mastectomy after finding she had advanced breast cancer at the age of 31 was an easy decision.
“The process of having a mastectomy is relatively simple. It’s honestly not painful, the surgery is relatively fast,” she said.
“It’s the chemotherapy, it’s the process of your mind getting used to what happening, it’s the affect on your entire life, the life of your loved ones, that’s really difficult.”
She says the benefits of reconstruction far outweigh the pain of losing a breast.
“It was one of the best feelings in my life,” she said.
“I had a fantastic surgeon. They were very careful in explaining the whole procedure to me.
“They look fantastic. It made me feel whole again and it made me feel very feminine again,” she said.
Topics:
breast-cancer,
diseases-and-disorders,
health,
actor,
film-movies,
arts-and-entertainment,
australia
First posted
Source Article from http://www.abc.net.au/news/2013-05-15/jolies-mastectomy-revelation-to-spark-gene-test-interest/4690366
Views: 0
Posted in 
