Historically, doctors recommended genetic screenings in certain women with a family history of breast or ovarian cancer. This month, Mary-Claire King, an influential the geneticist who discovered links between a gene called BRCA1 and breast cancer, said doctors need to offer genetic tests to all women 30 and older.
The American Cancer Society and the National Society of Genetic Counselors disagree. So does Jennifer Stroop, a genetic counselor at UConn. "We need more research to learn more about the overall cancer risk across the population," she said. "We have a fair amount of data about the cancer risks for BRCA carriers in women who have a strong family history," but Stroop said scientists don't fully understand BRCA's impact in women without a family history of breast cancer.
Stoop said any large-scale genetic testing would need to be offered in a more cost-effective, coordinated way, taking into account downstream impacts. "Making sure if someone is identified as a carrier, [that] they have access to the screening and management that they would be recommended to have," she said.
A very small fraction of breast and ovarian cancers come from "faulty" copies of these genes, but Stroop said carrying BRCA1 or 2 mutations can increase the lifetime risk of developing breast cancer to between 60 and 85 percent.
"We have a lot of admiration for Mary-Claire King and her work," Stroop said, while noting it was difficult to apply King's study, which focused on a high-cancer risk population of Ashkenazi Jews in Israel, to all women. "I think, overall, it's still premature to recommend BRCA 1 and 2 testing for the general population."
Last year, actress Angelina Jolie drew public attention to cancer and genetics by writing in the New York Times about how a BRCA1 mutation led her to get a preventive double mastectomy.
Earlier this month, King won the Lasker-Koshland Special Achievement Award in Medical Science, often called the field's "American Nobels." Her genetic testing proposal appears in the September issue of The Journal of the American Medical Association.
