Many women across the United States, and most likely around the world, were moved Tuesday by famous actress Angelina Jolie’s empowering story about her double mastectomy, the fact she has the cancer causing mutated* BRAC1 gene and the worldwide fight against breast cancer. However, Dr. H. Gilbert Welch of the Darmouth Insitute for Health Policy and Clinical Practice—while still praising Jolie for her bravery—warned in an op-ed piece Friday on CNN.com that Jolie might have “forgot to mention” something very important.
In Welch’s piece “What Angelina Jolie Forgot To Mention,” he discusses the massive amount of emails from colleagues who were concerned about the Jolie announcement. His students even wanted to discuss the subject in class.
According to Welch, he even received one email from a research fellow at the International Agency for Research on Cancer which read:
"I fear that this disclosure will motivate other women to undergo preventive mastectomy, even though they do not need it."
It wasn’t until Welch realized that Jolie’s story could affect and carry a lot of weight with women that he thought there may be an issue.
“If American women saw themselves in Angelina Jolie -- then that would be a problem. Because the logical next question is: Should I get a preventive mastectomy,” he writes.
According to Welch, there is an important bit of information about Jolie’s story that women should know, which he writes in bold black letters:
“NOTE: This story is not relevant to more than 99% of American women.”
This is due to the fact more than 99 percent of women do not have a mutated BRCA1 or BRCA 2 gene.
According to Welch, the mutated BRCA1 gene can cause a woman to be at five times more of a risk for breast cancer and at 10 times more of a risk for ovarian cancer. Therefore, preventative measures like a double mastectomy can have great benefit.
However, a woman who has normal risk, has less benefit to gain from preventative measures but just as much risk for complications from those same measures.
Jolie also suggests that women should be tested for the mutated BRCA1 gene, citing the 500,000 women who die across the globe from breast cancer each year. Welch points out that “90 percent of these deaths have nothing to do with BRCA1.”
According to Welch, the less than one percent of woman who have the BRCA1 gene usually find a history of it in their family.
Welch ends his piece by saying:
There's no one right choice for a woman in Angelina Jolie's position, but she may well have made the right choice for her. Luckily it is a choice most women don't have to face.
Read the full op-ed piece here.
*Correction: I previously stated the BRAC1 and BRAC2 genes create a higher risk for cancer. It is actually a mutated gene that creates the risk. Please read more here
