After actress Angelina Jolie announced her decision to have a double mastectomy back in May, it didn’t take long for synagogues and Shabbat tables in the Jewish community to buzz with a new conversation.
Her choice to have her breasts surgically removed touched a raw nerve within the community: while one in every 800 individuals is susceptible to the BRCA breast cancer gene, one in 40 Ashkenazi Jews test positive for it.
Jolie had tested positive for the BRCA1 gene, a genetic mutation with an 87% risk of leading to breast cancer, and a 50% risk of developing ovarian cancer. Since her family had a history of breast cancer, with her mother losing the battle at the age of 56, she made the difficult decision to minimize the risk.
The sudden awareness of the Jewish genetic makeup now has the community wondering if they, too, should get tested, and, if tested positive, what are some of the decisions they might have to face.
The Rohr Jewish Learning Institute, a Chabad-affiliated Brooklyn-based adult program for continuing education, aims to bring answers to some of those questions. Starting Sunday, October 27, JLI is launching a new education program in 362 neighborhoods around the world discussing Jewish medical ethics. The first of the six-week course will tackle the issues surrounding the BRCA gene: addressing the heightened risks of inherited breast and ovarian cancer within the Jewish community and discussing the religious obligations behind screening for mutations and seeking preventative measures.
BRCA1 and BRCA2 are human genes belonging to the tumor suppressors class. Normally, the genes ensure the DNA of the cell is stable and they help prevent uncontrolled cell growth. Mutations of these genes, however, are linked to the development of hereditary cancers. According to the Journal of Medical Genetics, those tested positive for the BRCA1 gene may develop cervical, uterine, pancreatic, and colon cancer— as well as the more common causes of the mutation, breast and ovarian cancer. Those tested positive with the BRCA2 mutation may have increased risk of developing pancreatic, stomach, gallbladder and bile duct cancer. Women who inherit the harmful BRCA gene are about five times more likely to develop breast cancer than women who don’t have the mutation, the National Cancer Institute explains.
There are several methods to detect the BRCA mutation, and these tests, which can cost thousands of dollars, are not necessarily covered by health insurance. Testing includes searching for changes in the BRCA1 and BRCA2 DNA, as well as searching for a change in proteins those genes produce with a sample of a blood test.
The BRCA gene is commonly found amongst Ashkenazi Jews as a result of the population living in small, insular communities throughout history. Higher results of genetic mutation garner amongst tight knit groups that marry into each other, according to the Program for Jewish Genetic Health. So while the Ashkenazi Jewish community is prone to mutations like BRCA and Tay-Sachs disease, other close-knit populations like African-Americans can carry sickle cell disease, and beta thalassemia is found within the Mediterranean population. So far, three different mutations of the BRCA gene have been found amongst Ashkenazi Jews.