Is mastectomy answer?

U.S. actress Angelina Jolie, fourth from left, arrives with her children, from left, Maddox, Zahara, Pax Thien and Shiloh, at New Tokyo International Airport in Narita, east of Tokyo, in this July 26, 2010 file photo. Oscar-winning actress Jolie said on Tuesday that she had undergone a preventive double mastectomy after finding out she had a gene mutation that leads to a sharply higher risk of both breast and ovarian cancer. / Reuters-Yonhap

By Yoon Ja-young

Many people seemed shocked when actress Angelina Jolie revealed that she had a double mastectomy to prevent breast cancer. The actress wrote in The New York Times earlier this week that she opted for it after finding out that she had an 87 percent chance of breast cancer as she carries a mutation in a gene called BRCA1. What if we turn out to have the mutation? Should we follow her path? Preventive mastectomy is one of the options for people with this mutation, but it isn’t the only answer, according to doctors. They stress that it is more crucial for women, especially those with family histories of breast cancer, to get a regular checkup.

Breast cancer is not rare in Korea. Around 16,000 people are diagnosed every year, and around 7 percent of them have a hereditary form. “Breast cancer is better treated compared with other cancers, and the survival rate is also high when diagnosed in its early stages,” said Professor Jung Seung-pil at Korea University Anam Hospital. “However, hereditary breast cancer is likely to develop at a younger age, and it can affect both breasts. As it is related not only to individuals but also family, those who suspect they have it in the family should consult doctors, to prevent it or get a diagnosis in its early stages through a regular checkup,” he added.

Hereditary breast cancer is known to be caused by mutations in genes called BRCA1 and BRCA2. According to the National Cancer Center, you have a 60 to 80 percent chance of getting breast cancer if you have them. Mutations in these genes are known to cause not only breast cancer but also ovarian and pancreatic cancer. The chances of ovarian cancer increase to 20 to 30 percent in people carrying them.

Prof. Jung pointed out that the family members share not only genes but also lifestyles. Hence, even if a person hasn’t got the genes, there can be environmental factors that may cause breast cancer. Such familial breast cancer makes up between 15 to 20 percent of breast cancer patients, the doctor said, adding a regular checkup on family members is also crucial in these cases.

Those with a family history of breast cancer are recommended to get intensive regular screening from a young age. They should do breast self examinations every month from 18 years of age, and from 25 years of age, they are recommended to get an examination by doctor every six months and a mammography once a year.

The options for the high risk group include taking Tamoxifen, having preventive mastectomy like the actress, or an ovarian resection, but the answer differs for each individual as situations and risks differ for everyone, according to the professor.

Do all women or all breast cancer patients need to check their genes to see if they have these mutations? The National Cancer Center said “No,” but it added that those with a family history should evaluate the risk through genetic consulting. If the risk turns out to be high, they should have the BRCA gene analyzed by deciphering their DNA.

People assume men are safe from this issue even if they have breast cancer running in the family, but the National Cancer Center says males with such a family history should consider gene typing as it can increase their risk of having breast or prostate cancer.