Jolie sways Indian women into mastectomy: Doctors

HYDERABAD: Hollywood star Angelina Jolie probably never thought in her wildest dreams that going public about her preventive double mastectomy would actually backfire nearly two years later in India.
Dozens of oncologists here said her advocacy of awareness about genetic abnormalities resulting in breast cancer have done more harm than good, as scared women are rushing to cancer genetics clinics to find out whether they too need such a procedure.
“The Jolie story caught us by surprise as we saw a number of families registering with our cancer genetics clinic shot up from 200 plus families in June 2013 to around 400 in June 2014,” Dr Rajiv Sarin of the cancer genetics unit of Tata Memorial Hospital, Mumbai, said at an ongoing cancer conference here.
In fact, a team of Indian oncologists recently authored a research paper titled: “Angelina's choice: private decision, public impact” and it appeared in Indian Journal of Medical Ethics-2014. The authors estimated the lifetime risk of the development of breast cancer among BRCA 1 (defective genes) carriers as 19 % at 40 years of age and 85% by the age of 70.
The million dollar question, however, is: Does one need to go for mastectomy if BRCA1 and BRCA2 defective genes are detected?
City doctors say women are scared to death as they are not aware that there are several alternatives that one could opt for in such a situation. They say close surveillance by way of undergoing MRI scans and mammography every six months, or taking Tamoxifen drug, an effective medicine in reducing the chances of breast cancer, are the best options. “The line between advocacy and creating a scare has become blurred. We are asking women in Hyderabad not to get scared,” said Dr P Raghu Ram, president-elect, Association of Breast Surgeons of India.
Recently, a group of 150 women with cancer history in their families, turned up to find out whether they face any breast cancer risk and should undergo mastectomy. “We recommended only two women for BRCA tests, and only one turned positive. That is the level of scare everywhere,” said Raghu Ram.
Tata Memorial Centre (TMC) director Dr R A Badwe, who was in the city to attend the Apollo Cancer Conclave, regretted that health decisions were now becoming popular ‘shopping choices’ rather than informed ones.
“It is shocking to know that there has been 100% increase in referrals from scared women around the country for detecting defective BRCA 1 and BRCA 2 genes from 2,000 to 4,000 in just one year after the Jolie incident,” Badwe said.
They found that 99% of the women do not merit a genetic test, as they did not fall in the high-risk group during genetic counseling. “Only 40 women (1%) of those referred (4000) tested positive for defective BRCA 1 and BRCA 2 genes,” disclosed Dr Badwe.