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Family history important in major decisions on breast health

May 14, 2013

Media Contact: Keith.O’, 413-794-7656

SPRINGFIELD – Popular actress Angelina Jolie has revealed that she has had a double mastectomy as a preventive measure after learning she was at high risk for breast cancer based on her family history and her own genetic profile.

Writing in The New York Times today, Jolie said her doctors estimated that she had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer over her lifetime based on genetic testing she underwent. The results showed that she carries a mutation of the BRCA1 gene raising her chances for breast or ovarian cancer.

“One of the most important things women can take away from today’s announcement is the importance of knowing your family medical history, including cancer of all kinds, but especially breast and ovarian cancer, and that goes for men with breast cancer, too,” said Dr. James Stewart, chief, Hematology/Oncology at the Baystate Regional Cancer Program.


According to the National Cancer Institute (NCI) women with BRCA1 or BRCA2 mutations are at a 60 percent risk for breast cancer. Breast cancer kills some 458,000 people each year, notes the World Health Organization.

Women who are candidates for testing are identified by their family history or their own personal history of breast and ovarian cancer. Not all women need to undergo genetic testing, which can be expensive and which may not offer any benefit to some patients.

“I understand the anxiety that women undergo knowing that someone in their family had breast cancer, and it can be either on your mother’s or your father’s side. But less than 10 percent of breast cancer is related to these inherited genes, and certainly most women are not in this higher risk category, even if there is a positive family history,” said Dr. Stewart.

“Women need to have a long conversation with their doctor. It’s not as simple as saying ‘let’s get tested.’ There needs to be a good reason to be tested, and then if the genetic test turns out to be positive, that opens up a whole range of questions of what to do next. It’s a very personal thing, and women need to know all their options,” he added.


Before doing any testing, the Baystate Medical Center oncologist said there should be a conversation about what one would do if the test is positive and if the test is negative.

“For women with a positive test, there are questions related to risk reduction for ovarian cancer. For women who have completed child bearing, it is often suggested that ovaries and tubes be removed. For breast cancer risk reduction, strategies usually include either intense screening with mammogram and MRI or surgical removal of breast tissue. These are not conversations that can be done quickly,” said Dr. Stewart.


Dr. Stewart said in Baystate’s oncology practice they make it a point today to identify families where there is an increased risk for breast and ovarian cancer, and educate women about the possibility of genetic testing.

“Features of such families include multiple women diagnosed with breast cancer at an early age, such as under the age of 50, on both sides of the family. Families with both breast and ovarian cancers are of interest,” he said.

For more information on the Baystate Regional Cancer Program, visit