Dr. Josette E. Spotts, MD, FACS, Breast Surgeon
Dr. Andres Resto, MD, Plastic Surgeon
Kari Neely, breast cancer patient
BY IAN MYLCHREEST -- Call it the Angelina Jolie effect. Women across the country and beyond are thinking about whether they might be in that relatively small group of women who should consider a prophylactic double mastectomy.
A panel of local cancer specialists and patients discussed the issue recently on KNPR. The marker for Jolie was a defective version of the BRCA 1 gene, said Dr. Josette Spotts, a breast surgeon with Comprehensive Cancer Centers of Nevada. That gives a woman an 80-90 percent chance of getting cancer in either breast. It also creates a very high risk of getting ovarian cancer
Kari Neel, a breast cancer patient found she had the disease but decided in 2008 that the time was not right to undergo a mastectomy. She has been undergoing tests twice a year to make sure that she has not had a recurrence of the disease. Waiting for those results, though, has proved such a harrowing experience that Neel has now decided that she should undergo a double mastectomy.
Despite recent criticisms Myriad, which monopolizes the genetic testing, is willing to help patients with lower co-pays and discounts, said Spotts.
A caller to the program named Linda said that she had a double mastectomy because she was worried by her “long family history” of breast cancer.
“I decided I wanted to do everything possible I could to keep it from having a chance to return,” she said.
Neel too had a family history of breast cancer – four generations on her mother’s side, so she had no hesitation in getting the test. She took herceptin, six weeks of chemotherapy and radiation for a year. The treatments were debilitating but she decided to have a positive attitude throughout.
“I lost my hair but I didn’t lose my life,” she said, laughing.
How do you know if you should undergo testing to determine whether you carry the BRCA gene?
Dr. Josette Spotts, breast surgeon, says her office recommends the following:
"A lot of it has to do with family history, but we do have guidelines that we go by, and we follow the National Cancer Consortium guidelines. It’s based on family cohorts and follow ups of patients and looking at their genetic makeup, but basically if you have any woman less than 45 they get tested for the gene. Any woman who has a family history whatsoever of someone in their family having ovarian cancer, i.e. Angelina Jolie, you get tested to see if you have the gene because it’s a much higher risk that an ovarian cancer patient will carry the gene than a breast cancer patient. Ashkenazi Jewish population, a family history of male breast cancer is very very important."
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