Risk-reducing mastectomy rates in the US: a closer examination of the Angelina Jolie effect

Purpose In 2013, Angelina Jolie disclosed in the New York Times (NYT) that she had undergone risk-reducing bilateral mastectomy (RRBM) after learning that she was a BRCA1 mutation carrier. We examined the rates of BRCA testing and RRBM from 1997 to 2016, and quantified trends before and after the Jo...

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Bibliographic Details
Published in:Breast cancer research and treatment 2018-09, Vol.171 (2), p.435-442
Main Authors: Liede, Alexander, Cai, Mona, Crouter, Tamara Fidler, Niepel, Daniela, Callaghan, Fiona, Evans, D. Gareth
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
BRCA1 protein
Breast cancer
Breast Neoplasms - diagnosis
Breast Neoplasms - epidemiology
Breast Neoplasms - etiology
Breast Neoplasms - surgery
Cancer diagnosis
Cancer research
Databases, Factual
Diagnosis
Epidemiology
Female
Gene mutation
Genes, BRCA1
Genetic screening
Genetic testing
Genetic Testing - statistics & numerical data
Heterozygote
Humans
Incidence
Jolie, Angelina
Mastectomy
Medicine
Medicine & Public Health
Middle Aged
Mutation
Oncology
Ovarian cancer
Prophylactic Mastectomy - statistics & numerical data
Public health
Public Health Surveillance
Statistical analysis
Surgery
Trends
Tumors
United States - epidemiology
Womens health
Young Adult
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Summary:Purpose In 2013, Angelina Jolie disclosed in the New York Times (NYT) that she had undergone risk-reducing bilateral mastectomy (RRBM) after learning that she was a BRCA1 mutation carrier. We examined the rates of BRCA testing and RRBM from 1997 to 2016, and quantified trends before and after the Jolie op-ed. Methods This observational study of insurance claims data representative of the commercially-insured US population (Truven MarketScan® database) measured BRCA testing and RRBM rates among females ≥ 18 years. Censoring events were breast cancer or ovarian cancer diagnosis, last follow-up date (September 2016), or death. Interrupted time series analyses were used to quantify trends before and after the op-ed. Results Angelina Jolie’s NYT op-ed led to a statistically significant increase in the uptake of genetic testing and in RRBM among women without previous diagnosis of breast or ovarian cancer in the US population, and in women who did not undergo testing for BRCA ( P  
ISSN:0167-6806
1573-7217
DOI:10.1007/s10549-018-4824-9