Breast cancer expert, Dr. Devra Davis’ Afterthoughts on the

Angelina Jolie announcement

The press and the public lauded actress Angelina Jolie recent health decision to diminish her risk of breast cancer by opting for a prophylactic mastectomy. But according to experts, if the multi-millionaire actress were a poor woman under Medicare, she would not have been able to make this decision.  Medicare only covers the test after diagnosis of cancer, and does not allow it to be used for those who may be at increased risk of developing the disease.  In fact, studies have found that BRCA is much more common in young black women with breast cancer than in any other group tested in the U.S. so far.

Angelina Jolie is a very unusual woman in many ways.  The Academy Award winning actress inherited a genetic mutation that is shared by less than 1 in 20 women who develop breast cancer.   Of the 232,340 women diagnosed with breast cancer this year, she is one of 16,668 or as a few as 2,323, born with an inherited risk of the disease.  

In fact, her decision to have a mastectomy is not relevant to most women.  Most of those who develop breast cancer start life with healthy genes.  Their illness arises as a result of things that happen to them during their lifetimes including environmental exposures.

Many, including Dr. Davis, have spoken regarding the BRCA test itself, the underlying science was funded extensively by some $2.7 billion for the National Genome Project from the government as well as by Myriad Genetics, the company that has patented the gene’s testing.  It may be coincidence that the Supreme Court is about to decide whether it is legal for one company to patent the test for identifying these genes.  It’s a good thing that having a mother, grandmother or father’s sister or first cousin with breast cancer before age 40 is one indicator of the risk, because most women cannot afford the cost of the test—which runs up to $3500. 

All this focus on genes ignores one basic fact about breast cancer:  There is sufficient evidence that many cases of breast cancer arise from environmental factors.  Yet when it comes to controlling or reducing these avoidable causes of breast and other cancers, our society remains under the thrall of failed policies.  Before we can agree to take steps to prevent cancer arising from profitable agents with pricey genetic testing, we insist on proof that people have become sickened because of specific exposures to existing products–think tobacco and asbestos. 

The EHT and Dr. Davis have devoted great research in this space, please read about environmental risks on our page: https://ehtrust.org/environmental-risks-of-breast-cancer/