It’s not unusual that human interest stories covering a specific health issue can lead to an increased interest in a particular health service. These surges in awareness are however generally quite short-lived.
但是在2013年5月安吉丽娜·朱莉（Angelina Jolie）revealedthat she carried a maternally inherited pathogenic BRCA1 mutation and had undergone surgery to remove the risk of developing breast cancer, known as bilateral risk-reducing mastectomy (BRRM). The story was covered by all kinds of news outlets for several weeks.
According to her article, Angelina Jolie lost her mother, grandmother and aunt to cancer and decided to take matters into her own hands to spare her children the grief of losing their mother too. The honest and very informative nature of ‘My Medical Choice‘提高了社区中家庭癌症的认识，并鼓励妇女考虑基因检测。
Additionally, the glamorous image of the celebrity herself might have lessened women’s fears of losing their sexual identity post preventative surgery.
去年年底Breast Cancer Research出版文章that assessed the so-called ‘Angelina Jolie effect’ on the increase of referrals to genetic testing facilities as well as enquiries about risk-reducing surgeries.
As it takes 9–12 months from initial enquiry to surgery, they were not able to report on the increase of procedures at that time.
Referral rates were around 2.5-fold higher in June and July from 1,981 in 2012 to 4,847 in 2013 and around 2-fold higher in August through to October. The referral rates then settled to 32% higher towards the end of the year.
研究人员还强调了对BRRM的兴趣增加。但是，由于从初步调查到手术需要9-12个月，因此他们无法报告当时的程序增加。
研究人员现在证实了他们在给编辑的信， 出版于Breast Cancer Research今天。他们发现，从2014年1月到2015年6月，在诊所进行的预防双乳腺切除术数量增加了一倍以上，在此期间进行了83次手术，而2011年1月至2012年6月之间进行了29次。
We spoke to the author of both articles, Gareth Evans, Professor of Medical Genetics and Cancer Epidemiology at The University of Manchester and Professor of clinical genetics at theGenesis Breast Cancer Prevention Centre.
What is BRCA1 and what is its significance in breast cancer?
BRCA1 is a gene involved in repairing DNA by a pathway known as homologous recombination. About 1 in 1000 people carry a fault in the BRCA1 gene that they have inherited in one of their two copies.
BRCA1的错意味着，女性患乳腺癌的风险在40-85％之间，卵巢癌风险40-60％。
转介的2.5倍增加远远高于围绕家族性乳腺癌的任何宣传。
You report a 2.5 fold increase in referrals of UK women with a family history of breast cancer following Angelina Jolie’s public announcement. How does this figure compare to your expectations?
转介的2.5倍增加远远高于围绕家族性乳腺癌的任何宣传。It therefore far exceeded our expectation both in the amount of the increase and the longevity of it.
您提到没有突变的人的BRRM率也会增加。所有患者是否需要该程序？
BRRM is a choice for women at high risk of breast cancer with or without known BRCA mutations. It is not advised that all women should have BRRM just that this should be an option for them.
您的工作有什么影响？
It is likely that there will be a greater need for operation time for BRRMs which take between 3-6 hours with skin sparing approach and immediate reconstruction. More surgeons may need to be trained to accommodate the extra demand.
Do you have any further research planned to investigate the ‘Angelina Jolie effect’?
我们计划继续遵循安吉丽娜（Angelina）的启示刺激的转诊和手术趋势。
Angelina Jolie has recently writtenanother piece for the New York Timesin which she describes in much detail why she underwent another preventive surgery, the removal of her ovaries and fallopian tubes. It would be interesting to see if this will have an effect on the number of these risk-reducing surgeries too.
注释