Researchers work to combat ‘Jolie effect’
OTTAWA • The day after actress Angelina Jolie revealed in 2013 that she had both of her breasts removed to prevent cancer, Ottawa surgical oncologist Dr. Angel Arnaout had a “swarm” of people at her clinic “asking, all of a sudden, why they couldn’t get the other side taken off.”
Jolie had the surgery because she carries the BRCA1 gene mutation, which puts her at a 60- to 80-per-cent lifetime risk of cancer in both breasts. But only 15 per cent of women with breast cancer carry such mutations.
And yet, Arnaout was hearing from patients with cancer in one breast and no greater risk than the average person of developing it in a second breast. Suddenly, many women wanted both breasts removed.
“There is no reason to remove the opposite breast and yet they are requesting it and it is happening at an increasing rate,” said Arnaout, a surgical oncologist with The Ottawa Hospital.
The “Jolie effect,” as it has been called, is real and Arnaout says she has talked to many other physicians who have seen the same thing. But it is just one factor in a worrying trend in Ontario: a growing number of women are opting to have a healthy breast removed after a diagnosis of cancer in the other breast, a move that puts them at greater risk of surgical and post-surgical complications that, in some cases, can delay cancer treatment.
Arnaout and Dr. Janet Squires, a behavioural scientist in the clinical epidemiology program at The Ottawa Hospital Research Institute and an assistant professor of nursing at the University of Ottawa, are studying the trend in Canada. They hope to better understand the phenomenon and to develop interventions to reduce the number of unnecessary breast removals. They have received a $100,000 Knowledge to Action Grant from the Canadian Cancer Society, as well as a $99,000 grant from the Ontario Institute for Cancer Research.