The Angelina Effect: more women get breast cancer testing

It has been called the Angelina Effect.  Angelina Jolie, the Academy-Award-winning actor and celebrity, shocked the world last year when she revealed that she had undergone a double mastectomy after genetic testing showed she was at a higher risk of developing breast cancer. Given Ms. Jolie's celebrity, doctors wondered what impact her announcement would have on referrals for genetic testing . A new study by a team at Sunnybrook Health Sciences Centre in Toronto showed referrals at its cancer clinic almost doubled.

In an opinion piece in the New York Times in May, 2013, Ms. Jolie explained that she had an extensive family history of breast and ovarian cancer, and a positive test for the BRCA1 gene mutation confirmed that she was at a much higher risk of developing cancer.

Dr. Andrea Eisen, head of Preventive Oncology at Sunnybrook`s Odette Cancer Centre who oversaw the study, told Carol she felt Ms. Jolie's admission saved lives.

"I really think she did. It was a very brave and important thing to do and we've certainly seen in our own clinic setting a far greater number of women coming forward for genetic assessment than before her story became public."

The Sunnybrook team compared the number of referrals to the Odette Cancer Centre during the six months before Ms. Jolie's admission, to referrals during the six months after.

The team also tracked the number of those referrals, both before and after Ms. Jolie's article, that qualified for genetic testing for the BRCA1 and 2 mutations. Women with either gene mutation have roughly a 60 per cent greater chance of developing cancer during their lifetime.

The numbers were positive on both fronts. Referrals jumped 90 per cent - from 483 to 916 - and those who qualified for testing jumped 105 per cent - from 213 to 437.

"The women who came forward were women who were truly at high risk," Dr. Eisen said. "The proportion of women who turned out to be eligible for testing in Ontario based on their family history was the same before and after her story, which suggests that it wasn't just women who had more modest family histories who became more aware after her news came out, but women who were truly at high risk."

After completing genetic testing, the number of women identified who were carrying the gene mutation jumped 110% - from 29 before to 61 after.

Roughly a third of the patients at Sunnybrook's Odette Cancer Centre who had the mutation elected to go ahead with double mastectomies. But Dr. Eisen stressed that the invasive procedure is not the best treatment for all patients, and there are other treatment options available, such as more vigilant screening or other, less invasive surgeries.