Angelina Jolie was found to have a BRCA mutation and publicly announced her decision to have major risk-reduction surgery. “That led to a lot of public awareness… so,many more women are much more aware,” Dr. Ganz said. “They’re going to ask their doctors about testing if they have a breast cancer diagnosis.”
Also, guidelines have changed, and rather than looking only at family history, clinicians are testing almost any breast cancer patient under age 50 for BRCA. “So I would suggest that perhaps temporal trends may have alleviated some of this disparity,” she said, “and it will be very interesting if Dr. Pal or others recruit a more contemporary sample [and] if we see some shift in this kind of difference in testing and decision making.”
Another factor affecting contemporary BRCA testing is the U.S. Supreme Court’s rejection in 2013 of the patents on the original test, resulting in about a 90% reduction in the cost of the test, making it more affordable for more women. Finally, because a breast cancer diagnosis is devastating to many women, they may choose to pursue breast cancer treatment and risk reduction strategies before addressing their ovarian cancer risk. Therefore, it may be worthwhile to conduct follow up studies to track these women’s cancer risk management choices over time.
The study received funding from the Bankhead Coley Cancer Research Program and the American Cancer Society. Dr. Pal reported no financial disclosures. Patricia Ganz, MD reported stock and other ownership interest in Abbott Laboratories, GlaxoSmithKline, Johnson & Johnson, Merck, Novartis, Pfizer, and Teva.