Angelina Jolie’s Most Challenging Role Yet

May 16, 2014
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Dr. Denise Johnson Miller

Dr. Denise Johnson Miller

By Meridian Health

Last year, Oscar-winning actress Angelina Jolie revealed in a candid and sensitive New York Times Op Ed piece that she had tested positive for the BRCA1 gene – a “faulty” gene mutation indicating a woman’s increased chance of developing breast and ovarian cancers.

Jolie, now 38 and mother of five young children, lost her own mother to cancer when her mother was just 56 years old. The actress chose to have a preventive double mastectomy. She also decided to go public with her very private experience, and shine a spotlight on the progressive role of gene therapy in the battle against breast cancer, and the tough decisions faced by many women.

“The BRCA1 gene produces tumor suppressor proteins which help repair damaged DNA. If this gene doesn’t work properly, cells are more likely to develop genetic alterations that may lead to cancer,” said Denise Johnson Miller, M.D., FACS, director of breast surgery at Jersey Shore University Medical Center, a Meridian Health hospital.

Meridian Health Cancer Genetic Coordinator Angela Musial Fay, MS, CGC, adds, “Women who carry a BRCA1 or BRCA2 gene mutation have up to an 87 percent chance of developing breast cancer, and up to a 44 percent chance of developing ovarian cancer. The prevalence of carrying the gene is also higher for some ethnicities, including those of Eastern European Jewish ancestry.”

In Jolie’s editorial, entitled “My Medical Choice,” she chronicles her decision-making process, as well as the painful physical process of undergoing a double mastectomy. She details the complex medical procedures that spanned the course of three months, and ultimately based her decision to “take action” and undergo the procedure as a personal, preventive health choice guided by genetic testing results and counseling. Jolie wrote: “Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much as I could.

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“My chances of developing breast cancer have dropped from 87 percent to under 5 percent,” she wrote.

Women are referred to a certified genetic counselor often by their primary care physician, OB/GYN or by a radiologist during a routine mammography when certain risk criteria are identified. “During the genetic counseling session, we review the patient’s medical and family background to see if they are candidates for BRCA1 or BRCA2 gene testing,” Musial Fay said. “Fortunately, most insurance companies will cover the testing if the criteria are met.”

Johnson Miller emphasizes, “Angelina’s decision was not an easy one to make, and it was based on her own personal health and circumstances. What’s important for a woman to know is that if she tests positive for a BRCA1 or BRCA2 gene mutation, she should consult her physicians, including medical gynecology and gynecologic oncologists and breast surgeons and genetic counselors experienced with familial gene-based cancers. There are many options available to women who test positive for the gene including regular, increased surveillance, chemoprevention and surgery. Women should make informed decisions. At Meridian, cancer care specialists and genetic counselors work as a coordinated team with patients to create a care plan that best suits a woman’s unique medical and personal needs.”

Genetic testing is an exciting, dynamic area of health care that provides opportunity, hope and even controversy, especially for the prevention and treatment of breast cancer, which affects one in every eight women in the United States. But all experts agree that information is ultimately empowerment.

Since Angelina Jolie’s editorial, much attention has been focused on the role of genetic testing and breast cancer detection. Although she is best known as an award-winning actress and for her work as a humanitarian, Jolie’s heartfelt editorial has also cemented her role as a breast cancer awareness advocate.

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Meridian Health System is the sponsor of the Paint the Town Pink initiative.

The Two River Times is once again a sponsor of Paint the Town Pink, a breast cancer awareness initiative sponsored by Meridian Health System. Additional information about Paint the Town Pink is available at






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