Genetic testing for breast cancer doubled due to 'Angelina Jolie effect'

By Kate Bass, B.Sc.Sep 19 2014

In May 2013 Angelina Jolie, who was then Hollywood's highest-paid actress, underwent a double mastectomy after testing positive for a BRCA1 gene mutation that significantly increases the risk of developing breast cancer. A recent study, published by Breast Cancer Research has found that, public knowledge of her decision doubled NHS referrals for genetic testing for breast cancer risk.

Angelina Jolie had seen her mum die of breast cancer and her aunt was dying of breast cancer. She did not want the same to happen to her. Having tested positive for the same mutation present in her mother and aunty, which put her at a 45–90% risk of developing breast cancer, she decided the best option was to have both breasts surgically removed.

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Public knowledge of celebrities developing cancer, eg, Jade Goody, Kylie Minogue, has increased screening rates for several months following the announcements. In order to assess the impact of Angelina Jolie making public her decision to undergo preventative surgery, researchers analyzed data from 12 breast cancer family history clinics and 9 regional genetic testing centres in the UK from 2012–2013.

They found that there was an immediate increase in GP referrals to family history clinics after Ms Jolie's announcement. Referral rates were two-and-a-half times higher in June and July 2013 compared with the same period in 2012. A two-fold increase in referrals persisted until October 2013. The team also report that the demand for genetic testing almost doubled and that there were more enquiries about elective mastectomies. Such surgery is only recommended for patients with a very high risk of breast cancer.

Baroness Delyth Morgan, chief executive at the charity Breast Cancer Campaign, praised Angelina Jolie’s decision to go public “Without Angelina Jolie’s openness in talking about her BRCA1 mutation and decision to have a risk-reducing mastectomy, followed by the publication and publicity around the updated NICE guidelines soon after, many women may not have approached health services and so would never have had their risk and risk-reducing options explained,” she said.

Professor Evans, the study author, added that the glamorous and strong image portrayed by Angelina Jolie may have increased the impact of her announcement:

This may have lessened patients’ fears about a loss of sexual identity post-preventative surgery and encouraged those who had not previously engaged with health services to consider genetic testing.

It is recommended that women who have a family member with breast, ovarian, fallopian tube or peritoneal cancers be assessed to determine whether their family history of such cancers may be linked to BRCA gene mutations.