Angelina Jolie Reveals Double Mastectomy

Black women are 49 percent less likely than white women to get tested for the mutated genes, but the Affordable Care Act should close that disparity.

Photo by cinemafestival/Shutterstock

By Dara Sharif

Photo by cinemafestival/Shutterstock

Actress Angelina Jolie is being hailed as an inspiration after revealing that she recently underwent a preventive double mastectomy.

The procedure is a move to cut the risk of breast cancer, a disease doctors told Jolie she had an 87 percent chance of developing due to a mutated BRCA1 gene. (Women with a strong family history of breast or ovarian cancers sometimes opt to test for a mutation of this gene to help determine the likelihood of developing the disease.)

Jolie's mother was only 56 when she lost her own battle with ovarian cancer. In an op-ed piece that appeared in Tuesday's New York Times, Jolie shared that she chose the mastectomy in hopes of sparing her six children from losing her in a similar manner.

"The decision to have a mastectomy was not easy," Jolie wrote. "But it is one I am very happy that I made. My chances of developing breast cancer have dropped from 87 percent to under 5 percent. I can tell my children that they don't need to fear they will lose me to breast cancer."

BRCA is an acronym for two breast cancer susceptibility genes, which normally serve as tumor suppressors, according to the National Cancer Institute. However, mutations of the BRCA1 and BRCA2 genes have been linked to hereditary breast and ovarian cancer. A blood test can determine if a woman is "highly susceptible" to the cancers.

While Jolie's decision may spur other women to take this preventive measure, Black women may not be as quick to do so, even though as a group, they have the highest breast cancer death rates of all racial and ethnic groups and are 40 percent more likely to die of breast cancer than white women. Black women not yet diagnosed with breast cancer are 49 percent less likely than white women to get genetic testing, even though they have about the same risk of having an abnormal BRCA1 or BRCA2 gene as white women, and even if their doctors recommend it.

Why this disparity? Part of the reason is likely cost. The BRCA analysis costs as much as $3,000 and is currently covered only by some health-insurance policies. But under the Affordable Care Act, this testing is going to be completely covered by insurance as a preventive service for those women whose physicians recommend it. It's likely that physicians will recommend BRCA testing for Black women who are diagnosed with breast cancer at a young age or have a close relative who was diagnosed with breast cancer before age 35—a high-risk factor.

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