Angelina Jolie goes public with elective double mastectomy

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Angelina Jolie describes her very personal struggle with facing the possibility of breast cancer in a powerful op-ed for The New York Times today. Jolie reveals her decision to undergo a prophylactic (preventive) double mastectomy, reducing her risk of breast cancer from 87 percent to just 5 percent. While we often find celebrities on the wrong side of science and health issues, this is an example of how public figures can bring recognition to beneficial, and sometimes difficult, health decisions.

Jolie chose to make the story public in hopes of helping other women in their own struggles with breast cancer. Acknowledging that each woman s personal experience with breast cancer varies, she explains that on a personal note, I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity.

Jolie also highlights the importance of having the information necessary to make informed decisions about one s health. For any woman reading this, I hope it helps you to know you have options. I want to encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices, Jolie wrote.

While the Oscar-winning actress emphasizes being informed of personal health risks, each woman needs to address what sort of screenings will be beneficial, and how often that should happen with their own doctor.

The testing that allowed Jolie to be aware of her faulty BRCA1 gene, which is associated with a 65 percent increased risk on average for developing breast cancer, is actually at the center of a Supreme Court case.

Myriad Genetics currently holds a 20 year patent of the BRCA1 and BRCA2 genes commonly associated with hereditary breast and ovarian cancer. Their patent gives them full control over use of the genes for research and diagnostic testing. The Supreme Court heard arguments April 15 addresses the legality of patenting human genes. According to critics, ruling in favor of gene patenting would result in higher prices for diagnostic tests as monopolies develop.

The cost of testing for BRCA1 and BRCA2, at more than $3,000 in the United States, remains an obstacle for many women, says Jolie. (Although according to Myriad, over 90 percent of the 500,000 tests it has run have been covered by insurance, with the average woman paying just $100 out-of-pocket).

Although patents, such as this, sometimes result in high costs for testing, they also encourage innovation in the biotechnical industry. According to ACSH s medical director, Dr. Gilbert Ross, there could be a subtle, but very chilling effect on innovation in research and development without enforceable patents and proper compensations for developing of such advances.

While the sentiment of making lifesaving testing affordable is appropriate, it is still unclear exactly how this can happen without adversely affecting innovation in the biotechnical industry.

For more information check out this week's Medical Wrap.