The internet has been abuzz since yesterday morning, when activist and celebrity extraordinaire Angelina Jolie released an op-ed revealing that she had undergone an elective double-mastectomy, after finding out that she carries the BRCA1 gene mutation, which puts her at a vastly increased risk of developing breast cancer. By removing both of her breasts, she has reduced her risk to a mere 5% chance of developing the disease, down from 87%.

The floodgates of speculation have now been opened: what effect will Angelina's revelation have on the wider population. The celebrity effect on health trends has already been documented, as was the case with Katie Couric and colorectal exams. Will it incentivize women to be more proactive about being screened for breast cancer. Will it make women currently undergoing treatment for breast cancer feel pressured to choose an aggressive treatment option, like a double mastectomy.
One thing that the concerned public should keep in mind is that the alarming statistic of 87% is not solely caused by the BRCA1 mutation. As stated in Angelina's op-ed, although the faulty gene still poses a high risk at 65% chance of developing breast cancer, a number of other factors have elevated the risk percentage, such as her family history. Although these statistics are impressive to quote, it presents a question of whether or not the article will fear-monger and affect women's decisions in their quest in preventing of breast cancer.
Topics pertaining to women's health, particularly breast cancer screening rates, are constantly a hotly debated topic in the US. As mentioned in a previous post, overdiagnosis is a primary concern and is used as an arguing point against high screening rates. The US is considered to be one of the most vigilant countries with regards to both breast cancer awareness as well as the protection of screening coverage for women. Screening is typically performed using mammograms to determine the presence of lesions within the breast tissue.
Angelina's article now presents a new concern and a new form of testing and screening that will join the discussion. The issue of the BRCA1 genetic testing, however, remains a controversial one. For one, the exorbitant cost of testing for the genetic mutation makes it prohibitive for most women. Additionally, there is the fact that 98% of all breast cancers in women do not have BRCA mutations.  Right now, Angelina's revelation runs the very real risk of obfuscating some of the more widespread causes of breast cancer by focussing on a gene mutation that affects very few.
Angelina opted to reconstruct her breasts with implants. It will be very interesting to see the effect her revelation will have on relevant medtech industries. As we have previously noted, the proportion of women who undergo reconstruction after a mastectomy is astonishingly low. Going forward, women may be more inclined to undergo breast reconstruction after a mastectomy, because, if anything, Angelina's revelation has made it more socially acceptable for women to do so. In the very least, the number of inquiries and questions brought up to physicians is expected to increase exponentially over the next while as the awareness of preventive mastectomies skyrockets.

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