The 'prophylactic' removal of women's breasts due to BRCA1/BRCA2 status has become a disturbingly popular trend, and increasingly it is being celebrated in the mainstream media and medical establishments as a reasonable choice. But does the scientific evidence itself refute this approach?
Angelina Jolie's recent announcement in a New York Times op-ed
that she had a 'prophylactic' double mastectomy due to her BRCA1/BRCA2
status has disturbing implications, some of which we covered late last year in connection with Allyn Rose, the 24-year old Miss America contestant who announced she would be undergoing a double mastectomy to "prevent" breast cancer
Beyond the fact that as high-profile celebrities their decisions will affect millions of women's perception of the procedure, likely making them more accepting of the concept, their decisions also reflect profound misconceptions about gene-mediated disease risk embedded deeply within popular consciousness, from which prevailing medical opinion is hardly immune.
First, there is a common misconception about the role that the so-called breast cancer susceptibility genes, BRCA1 and BRCA2, play in breast cancer disease risk and prognosis. BRCA mutations vary widely by ethnicity and are exceedingly rare in the general population, which is why, as NBCNews.com recently reported
, "The U.S. Preventive Services Task Force recommends that only women with a strong family history even think about getting a BRCA genetic test - which is only 2 percent of U.S. women." But even in those in which a BRCA mutation is identified, the genes, in and of themselves, do not alone make the disease.