Angelina Jolie sparked a global discussion about hereditary breast cancer, caused by the inheritance of mutated BRCA1 and BRCA2 genes, after publishing a powerful essay in The New York Times about her decision to undergo a preventative double mastectomy after learning that her late mother had passed down the BRCA gene mutation.
Naturally, it has brought attention to BRCA gene testing or screening, which can detect mutations and risk of getting hereditary breast cancer. In this virtual interview with Tatler, Dr Murallitharan M., managing director of National Cancer Society Malaysia, helps us understand the science behind BRCA gene testing and the reality of early breast cancer screening.
Dr Murallitharan M. has extensive experience in the field of non-communicable diseases. He continues to research public health policy in collaboration with Chulalongkorn University and the London School of Hygiene and Tropical Medicine where he was the ASEAN PhD fellow and Chevening Scholar respectively. He has also held positions as a medical officer and clinician at Hospital Kuala Lumpur, clinical epidemiologist for the Ministry of Health's Clinical Research Centre and medical director of MMPKV Healthcare Sdn Bhd.
What are the BRCA1 and BRCA2 genes?
Put simply, BRCA1 and BRCA2 genes are tumour suppressor genes that protect the body from cancer. They are coded to produce proteins—much like little soldiers—to repair DNA damage from smoking, alcohol, sunlight and external chemicals.
When these genes are mutated, the body’s protective mechanism cannot repair any damage and is unable to keep cells from multiplying rapidly and uncontrollably. This mutation is primarily connected to breast cancer and can also affect the ovaries, prostate and pancreas.
The most important thing about BRCA gene mutation is understanding the risk factor for someone who has a genetic history of cancer. If they have inherited this mutation, it can predispose them to getting breast cancer and unfortunately, the chances are much higher. A normal person has about 10 per cent chance of picking up breast cancer. By contrast, it goes up to 50 to 70 per cent for someone who has inherited the mutated gene from their mother or father.
A lot of the conversations about BRCA centre around the West. What is the prevalence of the BRCA gene mutation in Asian demographic?
In the beginning, nobody really looked at Eastern populations but our colleagues at Cancer Research Malaysia have found that the amount of mutations in Asian populations is just as high, if not higher, than the Western demographic. Their research indicates that 1 in 20 Malaysian breast cancer patients have inherited a genetic alteration in BRCA1 or BRCA2.
What does the BRCA gene mutation testing entail?
In Malaysia, we usually take a blood sample, send it off for genetic testing and receive the results within two weeks.