Why the Angelina Effect Is at Odds With New Guidelines

Genetic testing to prevent breast cancer isn't for everyone.

ByABC News
December 23, 2013, 3:37 PM

Dec. 23, 2013— -- It's official. The "Angelina Effect" that prompted many women to undergo genetic testing for the breast cancer gene isn't always such a good thing.

Actress Angelina Jolie shocked the world last May when she revealed that she'd undergone a preventive double mastectomy after learning that she carried the BRCA gene, a mutation that puts a person at higher risk for certain cancers.

She wrote in a New York Times op-ed, "I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer," she wrote. "It is my hope that they, too, will be able to get gene tested, and that if they have a high risk they, too, will know that they have strong options."

But the U.S. Preventive Services Task Force today warned that unnecessary BRCA testing could potentially cause harm.

"The USPSTF recommends against routine genetic counseling or BRCA testing for women whose family history is not associated with an increased risk for mutations in the BRCA1 or BRCA2 genes," it announced today.

Jolie had a strong family history of breast cancer before undergoing genetic testing. Her aunt died of breast cancer two weeks after the op-ed was published, and Jolie's mother had died of ovarian cancer at the age of 56.

Read more about the Angelina Effect.

The panel of doctors reviewed dozens of studies and released its findings in the Annals of Medicine journal.

"There is a very clear-cut algorithm for whether or not to test someone for a BRCA mutation," said Dr. Jennifer Ashton, a senior medical contributor to ABC News and practicing ob-gyn. "Simply having breast cancer in the family is not sufficient."

Read more about what Dr. Ashton thinks you should know about breast cancer.

According to the panel, only women who have a family history of breast cancer should be screened to determine whether they need genetic counseling. And they should undergo genetic testing for the BRCA gene only if the genetic counselor says it's necessary.

BRCA mutations are "uncommon," according to the Mayo Clinic. They're responsible for "about 5 percent of breast cancers and about 10 to 15 percent of ovarian cancers."

About 12 percent of women in the general population will develop breast cancer.

In contrast, 55 to 65 percent of women with the BRCA1 mutation will develop breast cancer, and 45 percent of women with the BRCA2 mutation will develop it, according to the National Cancer Institute.

Genetic testing has a moderate benefit for women who fit the criteria and are BRCA positive, but could be harmful to the majority of the population, according to the panel.

"Intensive screening for breast and ovarian cancer is associated with false-positive results, unnecessary imaging and unneeded surgery," the panel wrote in the report. For instance, taking a drug that reduces the risk of breast cancer was associated with an increased risk of blood clots.

Angelina Jolie's representatives did not respond to requests for comment.