The recent headlines-grabbing decision of Hollywood actress Angelina Jolie in undergoing double mastectomy after a gene linked to breast cancer was detected, has triggered a needless panic among young women, including patients afflicted with the disease and their relatives, averred cancer experts from leading medical institutions.
Firstly, even if either of the two genes -- BRAC1 and BRAC2 -- linked to breast cancer, was found in a woman, it did not mean that she would end up with malignancy. Only about 20 per cent of those carrying the gene were likely to develop breast cancer and there was little chance for the disease to develop in the remaining 80 per cent, said P. Vijay Anand Reddy, Director, Apollo Cancer Hospital and C.K. Naidu, senior surgical oncologist from the Basvatarakam Indo-American Cancer Hospital and Research Centre.
Emphasising the need to create awareness among people, Dr. Reddy said even if a woman underwent double mastectomy as a precautionary measure due to the presence of a gene, there was no guarantee that she would not develop breast cancer subsequently. “It is not foolproof as remnants of breast tissue would remain on the chest wall. It is a wrong notion to feel that one would be safe by undergoing double mastectomy,” he added.
He said women carrying the genes were at a greater risk of developing ovarian cancer than breast cancer. Such people should be subjected to ultrasound to detect ovarian masses as the chance of ovarian cancer was 10 to 20 times more compared to normal individuals.
Family history
According to Dr. Naidu, only 5 to 6 per cent of breast cancers were linked to genetic factors and 95 per cent had no genetic causes. If there was a family history, the chances were greater. Especially if first degree relatives like mother, father or sister had it. Testing for BRAC genes would be advised only if the patient came with a “significant family history”. He said that while BRAC 1 was associated with breast cancer, BRAC 2 was linked to both breast and ovarian cancers and was much more riskier, than the former.
He said that high-risk women with a family history need to be closely monitored and advised to take up periodic self-examination, clinical examination and undergo mammogram.
“They need not worry and can lead a normal married life,” he added.
Dr. Naidu said that prophylactic mastectomy was not the only option even if a woman had family history and was found to be carrying BRAC 1/2 gene. Other options include close monitoring, removing ovaries to curb hormonal effect and treatment with anti-cancer drug, tamoxifen.
