Longer term effects of the Angelina Jolie effect: increased risk-reducing mastectomy rates in BRCA carriers and other high-risk women
© Evans et al. 2015
Published: 25 November 2015
In May 2013 the actress Angelina Jolie informed the press that she had undergone bilateral risk-reducing mastectomy (BRRM) because she carried a maternally inherited pathogenic BRCA1 mutation. This decision created huge publicity worldwide  and led to enormous interest in hereditary breast cancer/genetic testing. Here we comment on our recently published research article in Breast Cancer Research and provide more recent observations. This reported a 2.5-fold increase in referrals of UK women with family histories of breast cancer 3–4 months following Ms Jolie’s revelation . We also highlighted increased interest in BRRM; however, as it takes 9–12 months from initial BRRM enquiries to the operative procedure, we can now report a similar 2.5-fold increase in uptake of BRRM in the 6–24 months following this.
The present audit of further new referrals and BRRM rates indicates that the Angelina effect has been prolonged and has impacted on increased referral and BRRM rates. It would be interesting to see results from centres worldwide. Plans to offer breast cancer risk assessment on a population basis could further affect uptake of BRRM . It is also possible that similar effects will be seen on the already increasing rates of contralateral mastectomy in women with breast cancer .
Bilateral risk-reducing mastectomy
Genesis Prevention Centre Family History clinic
This audit was sponsored with support from the Genesis Breast Cancer Prevention Appeal. The authors would like to thank other surgeons undertaking BRRM not named as authors on this letter (John Murphy, Ged Lambe, Siobhan O’Ceallaigh and Stuart Wilson), and breast care nurse Laura Potter.
Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
- Evans DG, Barwell J, Eccles DM, Collins A, Izatt L, Jacobs C, et al. The Angelina Jolie effect: how high celebrity profile can have a major impact on provision of cancer related services. Breast Cancer Res. 2014;16:442.PubMed CentralView ArticlePubMed
- Evans DG, Lalloo F, Ashcroft L, Shenton A, Clancy T, Baildam AD, et al. Uptake of risk reducing surgery in unaffected women at high risk of breast and ovarian cancer is risk, age and time dependent. Cancer Epid Biomarkers Prev. 2009;18:2318–24.View Article
- Evans DG, Graham J, O’Connell S, Arnold S, Fitzsimmons D. Familial breast cancer: summary of updated NICE guidance. BMJ. 2013;346:f3829.View ArticlePubMed
- Evans DG, Howell A. Can the breast screening appointment be used to provide risk assessment and prevention advice? Breast Cancer Res. 2015;17:84.PubMed CentralView ArticlePubMed
- Basu NN, Barr L, Ross GL, Evans DG. Contralateral risk-reducing mastectomy: review of risk factors and risk-reducing strategies. Int J Surg Oncol. 2015;2015:901046. doi:10.1155/2015/901046.PubMed CentralPubMed