By sharing her decision to undergo reconstructive surgery after a double mastectomy so publicly, Angelina Jolie greatly improved women's awareness of the subject.
"This is the first prospective report to prove the media's effect on the health care-related issue of breast cancer among the general public," says Dr. David B Lumenta, an assistant professor and senior physician at the Division of Plastic, Aesthetic and Reconstructive Surgery in the Department of Surgery at the Medical University of Graz in Austria.
The opportunity for the study arose when actress Angelina Jolie decided to discuss her choice to have a double mastectomy openly, as a team from the Medical University of Graz, led by Dr. Lumenta, had just carried out online research with 1,000 women on breast reconstruction after a mastectomy.
Jolie's story was covered widely in considerable detail across the media.
This unique research suggests that such broad media coverage of a high-profile case creates a "tipping point" - when, taking this example, the public's knowledge about a particular health topic becomes widespread.
In early 2013, Jolie underwent 3 months of medical procedures at the Pink Lotus Breast Center in California, including a double mastectomy and reconstruction. She told her story in The New York Times, sharing her decision-making process, the choices she had to make and the nature of the surgery she underwent.
"For any woman reading this, I hope it helps you to know you have options," Jolie wrote. "I wanted to write this to tell other women that the decision to have a mastectomy was not easy. But it is one I am very happy I made. My chances of developing breast cancer have dropped from 87% to under 5%."
- Together, BRCA1 and BRCA2 mutations account for about 20-25% of hereditary breast cancers and about 5-10% of all breast cancers
- Harmful mutations in BRCA1 and BRCA2 increase the risk of several cancers in addition to breast and ovarian cancer
- Several different genetic tests are available.
Jolie carries the BRCA1 gene mutation, which greatly increases her risk of developing certain cancers - notably breast cancer and ovarian cancer. It runs in her family; Jolie's mother, aunt and grandmother all died of cancer.
According to the National Cancer Institute, bilateral prophylactic mastectomy, as double breast removal is called, can reduce the risk of breast cancer in those who carry the BRCA1 or BRCA2 mutations. It can reduce the risk of breast cancer by 90% for women with a strong family history of cancer.
About 55-65% of women who inherit the BRCA1 mutation will develop breast cancer by the age of 70, compared with about 12% of women in the general population who will develop breast cancer sometime during their lives.
Two online polls with 1,000 women were carried out for the study. The first took place a month before Jolie's announcement, and the second was conducted a month after to take advantage of the unique opportunity that presented itself to the research team.
20% of women better able to deal with topic of breast cancer
The research found that following the announcement, there was a 4% increase in awareness that reconstructive breast surgery is possible, an 11% increase in awareness that breast reconstruction can be achieved with the use of one's own tissue, and a 19% increase in awareness that breast reconstruction can be done during the breast-removal operation.
Also, around 20% of women said that the media coverage about Jolie had made them "deal more intensively with the topic of breast cancer."
About 39% of women who carry the BRCA1 mutation will develop ovarian cancer in their lifetime. Since undergoing surgery to have both breasts removed, Jolie has also had her ovaries and her fallopian tubes removed.
Dr. Lumenta says:
"Since individual choice will become a driving force for patient-centered decision-making in the future, cancer specialists should be aware of public opinion when consulting patients with breast cancer."
Last month, a Spotlight feature from Medical News Today investigated the effect celebrities have on public health decisions.
Written by Jonathan Vernon