Recent headlines about Angelina Jolie, a well-known actress and movie producer, and her decision to have a prophylactic bilateral mastectomy to reduce risk for breast cancer have taken the world by surprise. In a recent article, Ms. Jolie outlined her genetic evaluation in which she was found to be the carrier of a mutation in a gene called BRCA1. Because of her gene status, she decided to reduce risk for breast cancer by removing her normal breast tissue.
Why would someone choose to have such a “radical” response to cancer risk? In order to understand the dilemma that many people face, it is important to know that Ms. Jolie’s situation is relatively unusual. In fact, mutations in BRCA1 and BRCA2 only account for 5 percent to 10 percent of breast cancers and 10 percent to 15 percent of all ovarian cancers every year. If a person is found to have a high-risk mutation, then prophylactic surgeries are one of several high-risk management options. In addition to surgery, there are certain medications as well as enhanced screening and surveillance available for these patients. An important point is that anyone considering this option should be evaluated by a specialist prior to making such an important decision.
The next question might be “how does someone know whether they are at high-risk for cancer?” Fortunately, there are genetic specialists and other health professionals who can help patients understand whether they are at high risk for cancer and then guide patients through the process of genetic testing. The process of genetic evaluation risk assessment and counseling is a new area of medicine called cancer genetics. Genetic professionals will use details from the family history to determine whether testing is a reasonable option.
The Vanderbilt-Ingram Cancer Center, a recognized leader in genetic medicine for cancer, has recently established the Clinical and Translational Hereditary Cancer Program with the primary mission to care for patients and families at high risk for cancer. Importantly, after patients are seen in the Hereditary Cancer Clinic, they can be referred to other caregivers, such as surgeons or high-risk nurse practitioners for further care.
- A small number of people will have an inherited risk for cancer
- It is important to know your family history of cancer
- Genetic evaluation and counseling is the first step in understanding cancer risk
- The VICC Hereditary Cancer Clinic at Vanderbilt University Medical Center is open to all patients for full evaluation and counseling
- Appointments can be made by calling (615) 343-7400
Georgia L. Wiesner, M.D.
Director, Vanderbilt Hereditary Cancer Program
Ingram Professor of Cancer Research and Professor of Medicine