In the wake of actress Angelina Jolie’s public announcements about her preventive bilateral mastectomy, the genetic mutation with which Jolie was born has risen to the forefront of some people’s minds.

Local doctors are quick to try and ease fears, since there are options to deal with the abnormality.

Dr. Melissa Hulvat at the Bass Breast Center at Kalispell Regional Medical Center said fewer than one percent of women have the genetic abnormality. The genes, BRCA 1 and BRCA 2, lead to a vastly increased rate in breast and ovarian cancer when mutated in affected individuals, as well as an increased rate of other types of cancer.

Hulvat said Jolie’s announcement took bravery and was an opportune time to have a discussion about breast and ovarian cancer. Before any sort of panic or move toward physical procedures takes place, however, Flathead Valley doctors say a consultation with a primary care provider is the first step.

“Not everybody needs to go out and get tested,” Hulvat said. “If you see some signs, you might need a consultation. Talk to your primary-care doctor.”

Some of the signs that can indicate BRCA mutations are: Any breast cancer before age 50, high-risk breast cancer before age 60, multiple family members with breast cancer before age 50, ovarian cancer at any age, male relatives with breast cancer, Ashkenazi Jewish ancestry or a known BRCA mutation in your family.

Dr. Brentley Buchele, a plastic surgeon who can perform reconstructive surgeries like the ones Jolie had, said the BRCA mutations shouldn’t be the real focus.

“Remember the real benefit of the Angelina Jolie story is not that there are a lot of women out there with the gene,” Buchele wrote in an e-mail. “The real story is that every woman has a risk of breast cancer. The average woman 40 years old and older needs a breast exam and screening mammography.”

The abnormality, while rare, accounts for between 5 and 10 percent of all breast cancer cases. Women with the BRCA 1 mutation have more than a 50 percent chance of developing breast cancer before age 70 while those with a BRCA 2 mutation have more than a 40 percent chance. Ovarian cancer rates range from 13 to 46 percent.

According to genetic counselor Betsy Smith at the Benefis Sletten Cancer Institute, women with the broken gene should be screened earlier, around 25 to 30 years old rather than 40.

“There are risk factors that might be hereditary,” Smith said. “The next step might be a referral to a genetic counselor. We want to start people in high-risk families earlier with mammograms and breast [imaging].”  

Dr. Michael Gordon, a board-certified oncologist at Glacier Oncology, said that there are options for women with the mutations besides a preventative mastectomy such as Jolie’s.

“It’s obviously a very personal decision,” Gordon said. “The genes are associated with breast and ovarian cancer and I’m sure Ms. Jolie made a thoughtful choice.”

Women who do have the genetic anomaly should get mammograms or breast MRI screenings every six months.

Ovary removal surgery reduces risk of cancer by up to 50 percent, Smith said. The gene becomes so dangerous because of hormones the ovaries produce, so their removal decreases chances of cancer. Hormone-blocking medications such as Tamoxifen also can help reduce cancer risk by up to 50 percent.

But all the doctors are quick to say that everything Jolie had done is readily available in the Flathead.

Hulvat vouched for Buchele’s plastic surgery work.

“Nothing can replace your own breasts,” Hulvat said. “But we can leave the skin and nipple and create some beautiful results.”

Reporter Ryan Murray may be reached at 758-4436 or by e-mail at rmurray@dailyinterlake.com.