Despite Angelina, People Misunderstand Breast Cancer Risk; Look Up Your Risk Online
Insurers Balk at Some Rare Genetic Tests for Breast Cancer
What's a BRCA Gene Anyway?
Why Angelina Jolie's 'Medical Choice' Is Likely Not Yours
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You can follow her on Twitter: \u003ca title=\"https://twitter.com/laliferis\" href=\"https://twitter.com/laliferis\">@laliferis\u003c/a>","avatar":"https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=blank&r=g","twitter":"laliferis","facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"news","roles":["subscriber"]},{"site":"futureofyou","roles":["subscriber"]},{"site":"stateofhealth","roles":["subscriber"]},{"site":"science","roles":["subscriber"]},{"site":"food","roles":["contributor"]}],"headData":{"title":"Lisa Aliferis | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/86c339d5cdcb0dcd2b6cf5d7c3f5886b?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/lisaaliferis"},"state-of-health":{"type":"authors","id":"8344","meta":{"index":"authors_1591205172","id":"8344","found":true},"name":"State of Health","firstName":"State of Health","lastName":null,"slug":"state-of-health","email":"stateofhealth@kqed.org","display_author_email":false,"staff_mastheads":[],"title":null,"bio":null,"avatar":"https://secure.gravatar.com/avatar/66de4bf6d331fa7402bba1ffe8135e17?s=600&d=blank&r=g","twitter":null,"facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"arts","roles":["author"]},{"site":"stateofhealth","roles":["editor"]}],"headData":{"title":"State of Health | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/66de4bf6d331fa7402bba1ffe8135e17?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/66de4bf6d331fa7402bba1ffe8135e17?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/state-of-health"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"stateofhealth_16859":{"type":"posts","id":"stateofhealth_16859","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"16859","score":null,"sort":[1387567974000]},"guestAuthors":[],"slug":"despite-angelina-people-dont-understand-breast-cancer-risk-look-up-your-risk-online","title":"Despite Angelina, People Misunderstand Breast Cancer Risk; Look Up Your Risk Online","publishDate":1387567974,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_12992\" class=\"wp-caption aligncenter\" style=\"max-width: 639px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/AngelinaJolie_GageSkidmore_Flickr-e1387567571124.jpg\">\u003cimg class=\"size-full wp-image-12992 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/AngelinaJolie_GageSkidmore_Flickr-e1387567571124.jpg\" alt=\"Angelina Jolie's decision to have a double mastectomy after genetic testing has prompted a discussion about which other tests should be covered. (Gage Skidmore/Flickr)\" width=\"639\" height=\"426\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/05/AngelinaJolie_GageSkidmore_Flickr-e1387567571124.jpg 639w, https://ww2.kqed.org/app/uploads/sites/27/2013/05/AngelinaJolie_GageSkidmore_Flickr-e1387567571124-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/05/AngelinaJolie_GageSkidmore_Flickr-e1387567571124-320x213.jpg 320w\" sizes=\"(max-width: 639px) 100vw, 639px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Gage Skidmore/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>In one of the bigger stories this year, actress Angelina Jolie caught both celebrity-watchers and health advocates off guard in May when she revealed in a \u003ca href=\"http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html\" target=\"_blank\">New York Times op-ed\u003c/a> that she had had a double mastectomy. She did this, she explained, because she carried a rare gene mutation that increased her likelihood of developing breast cancer to 87 percent.\u003c/p>\n\u003cp>Jolie's mother died of breast cancer at 56. Jolie was careful to explain why her situation was unusual. \"Only a fraction of breast cancers result from an inherited gene mutation,\" she wrote. About 5 to 10 percent of all breast cancers are related to a\u003ca href=\"http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA\" target=\"_blank\"> BRCA 1 or BRCA 2 mutation.\u003c/a>\u003c/p>\n\u003cp>But a new study shows that while her story certainly got a lot of attention, it unfortunately didn't do much to increase people's understanding of actual breast cancer risk.\u003c!--more-->\u003c/p>\n\u003cp>From \u003ca href=\"http://www.npr.org/blogs/health/2013/12/20/255558059/angelina-didnt-help-educate-people-about-breast-cancer-risk\" target=\"_blank\">NPR\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Researchers at the University of Maryland and Johns Hopkins surveyed over 2,500 Americans and found that while 3 out of 4 knew that Jolie had gotten a mastectomy, less than 10 percent properly understood Jolie's condition.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.npr.org/blogs/health/2013/12/20/255558059/Not%20so%20much,%20according%20to%20a%20study%20published%20this%20week%20in%20the%20journal%20Genetics%20in%20Medicine.\">results\u003c/a> were published this week in the journal \u003cem>Genetics in Medicine\u003c/em>. ...\u003c/p>\n\u003cp>Indeed, Jolie might have gotten some people more confused how a family history of cancer plays into an individual's risk, the survey found.\u003c/p>\n\u003cp>The researchers surveyed participants while Jolie's story was still fresh in their minds — within three weeks of when she published her piece in the \u003cem>Times\u003c/em>. ...\u003c/p>\n\u003cp>News coverage about Jolie's mastectomy tended to gloss over how rare her situation was, another \u003ca href=\"http://www.nature.com/gim/journal/vaop/ncurrent/full/gim2013199a.html\">recent study\u003c/a> found. The \u003ca href=\"http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA#r2\">genetic mutation\u003c/a> that Jolie has only accounts for 5 to 10 percent of all breast cancer cases.\u003c/p>\n\u003cp>It's not surprising that people don't retain the details, says \u003ca href=\"http://www.mailman.columbia.edu/our-faculty/profile?uni=rlk2\">Dr. Robert Klitzman\u003c/a>, director the graduate bioethics program at Columbia University, especially with rare and complex cases.\u003c/p>\n\u003cp>\"Overall the point is there was more awareness,\" he says. If more women are aware that their genes could affect their risk of breast cancer, they're more likely to ask their doctors about it, according to Klitzman.\u003c/p>\u003c/blockquote>\n\u003cp>But that doesn't mean every woman needs a blood test to determine whether she carries the BRCA mutation, as the American Cancer Society's chief medical officer Otis Brawley\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/14/why-angelina-jolies-medical-choice-is-likely-not-yours/\" target=\"_blank\"> noted in a statement\u003c/a> released hours after Jolie's piece was published.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Look Up Your Risk\u003c/strong>\u003c/p>\n\u003cp>The U.S. Preventive Services Task Force\u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrgen.htm\" target=\"_blank\"> recommends \u003c/a>that women whose family history of breast or ovarian cancer appears to put them at risk of having a BRCA mutation be referred for genetic counseling.\u003c/p>\n\u003cp>But even if you have a history of breast cancer in your family, it does not necessarily mean you have a BRCA mutation. \u003ca href=\"http://www.mdanderson.org/newsroom/news-releases/2009/women-with-brca-mutation-or-worry-most-likely-to-undergo-prophylactic-mastectomy.html\" target=\"_blank\">Only .1 to .2 percent of people\u003c/a> carry a BRCA 1 or BRCA 2 mutation.\u003c/p>\n\u003cp>You can assess your breast cancer risk by using this online screening tool from the \u003ca href=\"http://www.cancer.gov/bcrisktool/\" target=\"_blank\">National Cancer Institute\u003c/a>. But I also like this screening tool from the Georgia Breast Cancer Genomic Consortium \u003ca href=\"https://www.breastcancergenescreen.org/public.aspx\" target=\"_blank\">specifically to determine if you are at risk for hereditary breast or ovarian cance\u003c/a>r (i.e. breast cancer linked to a BRCA mutation). I have a family history of breast cancer on both my mother's and my father's side of the family. \u003ca href=\"https://www.breastcancergenescreen.org/public.aspx\" target=\"_blank\">The calculator\u003c/a> provided a plain English summary of my risk of having a BRCA mutation:\u003c/p>\n\u003cul>\n\u003cli>You are \u003cem>unlikely\u003c/em> to be at increased risk for Hereditary Breast/Ovarian Cancer.\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003cp>That is pretty clear.\u003c/p>\n\n","blocks":[],"excerpt":"Jolie's mother died of breast cancer at 56. Jolie was careful to explain why her situation was unusual. \"Only a fraction of breast cancers result from an inherited gene mutation,\" she wrote. About 5 to 10 percent of all breast cancers are related to a BRCA 1 or BRCA 2 mutation.\r\n\r\nBut a new study shows that while her story certainly got a lot of attention, it unfortunately didn't do much to increase people's understanding of actual breast cancer risk.","status":"publish","parent":0,"modified":1388176753,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":19,"wordCount":596},"headData":{"title":"Despite Angelina, People Misunderstand Breast Cancer Risk; Look Up Your Risk Online | KQED","description":"Jolie's mother died of breast cancer at 56. Jolie was careful to explain why her situation was unusual. "Only a fraction of breast cancers result from an inherited gene mutation," she wrote. About 5 to 10 percent of all breast cancers are related to a BRCA 1 or BRCA 2 mutation.\r\n\r\nBut a new study shows that while her story certainly got a lot of attention, it unfortunately didn't do much to increase people's understanding of actual breast cancer risk.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Despite Angelina, People Misunderstand Breast Cancer Risk; Look Up Your Risk Online","datePublished":"2013-12-20T19:32:54.000Z","dateModified":"2013-12-27T20:39:13.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"16859 http://blogs.kqed.org/stateofhealth/?p=16859","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/12/20/despite-angelina-people-dont-understand-breast-cancer-risk-look-up-your-risk-online/","disqusTitle":"Despite Angelina, People Misunderstand Breast Cancer Risk; Look Up Your Risk Online","path":"/stateofhealth/16859/despite-angelina-people-dont-understand-breast-cancer-risk-look-up-your-risk-online","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_12992\" class=\"wp-caption aligncenter\" style=\"max-width: 639px\">\u003ca href=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/AngelinaJolie_GageSkidmore_Flickr-e1387567571124.jpg\">\u003cimg class=\"size-full wp-image-12992 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/AngelinaJolie_GageSkidmore_Flickr-e1387567571124.jpg\" alt=\"Angelina Jolie's decision to have a double mastectomy after genetic testing has prompted a discussion about which other tests should be covered. (Gage Skidmore/Flickr)\" width=\"639\" height=\"426\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/05/AngelinaJolie_GageSkidmore_Flickr-e1387567571124.jpg 639w, https://ww2.kqed.org/app/uploads/sites/27/2013/05/AngelinaJolie_GageSkidmore_Flickr-e1387567571124-400x267.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/05/AngelinaJolie_GageSkidmore_Flickr-e1387567571124-320x213.jpg 320w\" sizes=\"(max-width: 639px) 100vw, 639px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Gage Skidmore/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>In one of the bigger stories this year, actress Angelina Jolie caught both celebrity-watchers and health advocates off guard in May when she revealed in a \u003ca href=\"http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html\" target=\"_blank\">New York Times op-ed\u003c/a> that she had had a double mastectomy. She did this, she explained, because she carried a rare gene mutation that increased her likelihood of developing breast cancer to 87 percent.\u003c/p>\n\u003cp>Jolie's mother died of breast cancer at 56. Jolie was careful to explain why her situation was unusual. \"Only a fraction of breast cancers result from an inherited gene mutation,\" she wrote. About 5 to 10 percent of all breast cancers are related to a\u003ca href=\"http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA\" target=\"_blank\"> BRCA 1 or BRCA 2 mutation.\u003c/a>\u003c/p>\n\u003cp>But a new study shows that while her story certainly got a lot of attention, it unfortunately didn't do much to increase people's understanding of actual breast cancer risk.\u003c!--more-->\u003c/p>\n\u003cp>From \u003ca href=\"http://www.npr.org/blogs/health/2013/12/20/255558059/angelina-didnt-help-educate-people-about-breast-cancer-risk\" target=\"_blank\">NPR\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>Researchers at the University of Maryland and Johns Hopkins surveyed over 2,500 Americans and found that while 3 out of 4 knew that Jolie had gotten a mastectomy, less than 10 percent properly understood Jolie's condition.\u003c/p>\n\u003cp>The \u003ca href=\"http://www.npr.org/blogs/health/2013/12/20/255558059/Not%20so%20much,%20according%20to%20a%20study%20published%20this%20week%20in%20the%20journal%20Genetics%20in%20Medicine.\">results\u003c/a> were published this week in the journal \u003cem>Genetics in Medicine\u003c/em>. ...\u003c/p>\n\u003cp>Indeed, Jolie might have gotten some people more confused how a family history of cancer plays into an individual's risk, the survey found.\u003c/p>\n\u003cp>The researchers surveyed participants while Jolie's story was still fresh in their minds — within three weeks of when she published her piece in the \u003cem>Times\u003c/em>. ...\u003c/p>\n\u003cp>News coverage about Jolie's mastectomy tended to gloss over how rare her situation was, another \u003ca href=\"http://www.nature.com/gim/journal/vaop/ncurrent/full/gim2013199a.html\">recent study\u003c/a> found. The \u003ca href=\"http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA#r2\">genetic mutation\u003c/a> that Jolie has only accounts for 5 to 10 percent of all breast cancer cases.\u003c/p>\n\u003cp>It's not surprising that people don't retain the details, says \u003ca href=\"http://www.mailman.columbia.edu/our-faculty/profile?uni=rlk2\">Dr. Robert Klitzman\u003c/a>, director the graduate bioethics program at Columbia University, especially with rare and complex cases.\u003c/p>\n\u003cp>\"Overall the point is there was more awareness,\" he says. If more women are aware that their genes could affect their risk of breast cancer, they're more likely to ask their doctors about it, according to Klitzman.\u003c/p>\u003c/blockquote>\n\u003cp>But that doesn't mean every woman needs a blood test to determine whether she carries the BRCA mutation, as the American Cancer Society's chief medical officer Otis Brawley\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/14/why-angelina-jolies-medical-choice-is-likely-not-yours/\" target=\"_blank\"> noted in a statement\u003c/a> released hours after Jolie's piece was published.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Look Up Your Risk\u003c/strong>\u003c/p>\n\u003cp>The U.S. Preventive Services Task Force\u003ca href=\"http://www.uspreventiveservicestaskforce.org/uspstf/uspsbrgen.htm\" target=\"_blank\"> recommends \u003c/a>that women whose family history of breast or ovarian cancer appears to put them at risk of having a BRCA mutation be referred for genetic counseling.\u003c/p>\n\u003cp>But even if you have a history of breast cancer in your family, it does not necessarily mean you have a BRCA mutation. \u003ca href=\"http://www.mdanderson.org/newsroom/news-releases/2009/women-with-brca-mutation-or-worry-most-likely-to-undergo-prophylactic-mastectomy.html\" target=\"_blank\">Only .1 to .2 percent of people\u003c/a> carry a BRCA 1 or BRCA 2 mutation.\u003c/p>\n\u003cp>You can assess your breast cancer risk by using this online screening tool from the \u003ca href=\"http://www.cancer.gov/bcrisktool/\" target=\"_blank\">National Cancer Institute\u003c/a>. But I also like this screening tool from the Georgia Breast Cancer Genomic Consortium \u003ca href=\"https://www.breastcancergenescreen.org/public.aspx\" target=\"_blank\">specifically to determine if you are at risk for hereditary breast or ovarian cance\u003c/a>r (i.e. breast cancer linked to a BRCA mutation). I have a family history of breast cancer on both my mother's and my father's side of the family. \u003ca href=\"https://www.breastcancergenescreen.org/public.aspx\" target=\"_blank\">The calculator\u003c/a> provided a plain English summary of my risk of having a BRCA mutation:\u003c/p>\n\u003cul>\n\u003cli>You are \u003cem>unlikely\u003c/em> to be at increased risk for Hereditary Breast/Ovarian Cancer.\u003c/li>\n\u003c/ul>\n\u003cp>\u003c/p>\n\u003cp>That is pretty clear.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/16859/despite-angelina-people-dont-understand-breast-cancer-risk-look-up-your-risk-online","authors":["240"],"categories":["stateofhealth_12"],"tags":["stateofhealth_518"],"featImg":"stateofhealth_16862","label":"stateofhealth"},"stateofhealth_12988":{"type":"posts","id":"stateofhealth_12988","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"12988","score":null,"sort":[1369762124000]},"guestAuthors":[],"slug":"insurers-balk-at-some-rare-genetic-tests-for-breast-cancer","title":"Insurers Balk at Some Rare Genetic Tests for Breast Cancer","publishDate":1369762124,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cp>\u003cstrong>By Michelle Andrews for \u003ca href=\"http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2013/052813-Michelle-Andrews-on-breast-cancer-care.aspx\" target=\"_blank\">Kaiser Health News\u003c/a> and \u003ca href=\"http://www.npr.org/blogs/health/2013/05/28/186885334/insurers-balk-on-rarer-genetic-tests-for-breast-cancer\" target=\"_blank\">NPR\u003c/a>\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_12992\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://www.flickr.com/photos/gageskidmore/4840431698/\">\u003cimg class=\"size-large wp-image-12992 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/AngelinaJolie_GageSkidmore_Flickr-620x413.jpg\" alt=\"Angelina Jolie's decision to have a double mastectomy after genetic testing has prompted a discussion about which other tests should be covered. (Gage Skidmore/Flickr)\" width=\"620\" height=\"413\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Angelina Jolie's decision to have a double mastectomy after genetic testing has prompted a discussion about which other tests should be covered. (Gage Skidmore/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>When it comes to inherited genetic mutations that increase the risk of breast cancer,\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/15/whats-a-brca-gene-anyway-angelina-jolie/\" target=\"_blank\"> BRCA1 and BRCA2 \u003c/a>get nearly all the attention.\u003c/p>\n\u003cp>Inherited mutations in these genes \u003ca href=\"http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA\" target=\"_blank\">cause from 5 to 10 percent\u003c/a> of breast cancers as well as up to 15 percent of ovarian cancers, according to the National Cancer Institute.\u003c/p>\n\u003cp>There are other, rarer genetic mutations that also predispose women to breast cancer.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Other genes besides BRCA1 and BRCA2 may have mutations that predispose a woman to breast cancer.\u003c/aside>\n\u003cp>Health insurers that cover BRCA-related testing and treatment without a hitch sometimes balk at providing coverage in these other instances. The predictive value of some of those variations isn't always as strong or clear-cut.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>When Angelie Jolie \u003ca href=\"http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html\" target=\"_blank\">said earlier this month\u003c/a> that she'd tested positive for a particularly harmful BRCA1 mutation and had a double mastectomy to substantially reduce her risk of getting breast cancer, she didn't mention her insurance coverage.\u003c!--more-->\u003c/p>\n\u003cp>But many health insurance plans \u003ca href=\"http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2013/052813-Michelle-Andrews-on-breast-cancer-care.aspx\" target=\"_blank\">routinely cover\u003c/a> genetic counseling and testing if a woman has a family history of breast or ovarian cancer. This is particularly true when there's a pattern of early breast cancer, with diagnoses of family members in their 40s, long before the mid-60s when most women develop the disease.\u003c/p>\n\u003cp>Under President Obama's Affordable Care Act, health plans that weren't grandfathered \u003ca href=\"http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/aca_implementation_faqs12.html\" target=\"_blank\">must cover genetic counseling and testing\u003c/a> in such women without requiring them to pay anything out of pocket for it.\u003c/p>\n\u003cp>Counseling can cost several hundred dollars, and the genetic test costs roughly $3,000. (The high cost is in part because one company, Myriad Genetics, holds the patent on the BRCA1 and BRCA2 genes. That patent has been challenged and is\u003ca href=\"http://science.kqed.org/quest/audio/bay-area-biotech-industry-braces-for-gene-patenting-court-case/\" target=\"_blank\"> currently under review \u003c/a>by the U.S. Supreme Court.)\u003c/p>\n\u003cp>But other genes besides BRCA1 and BRCA2 might have mutations that predispose a woman to breast cancer. Even though women may test negative for BRCA1 and BRCA2 mutations, some women's history clearly indicates a familial link.\u003c/p>\n\u003cp>\"These women come from families where breast cancer has been marching through the family in young women, with women in their 40s being diagnosed with breast cancer,\" said Stephen Edge, the medical director of the breast center at Roswell Park Cancer Institute in Buffalo, N.Y.\u003c/p>\n\u003cp>These women may well have inherited other genetic mutations, probably related to complex interactions with other genes, that haven't yet been identified, said Edge.\u003c/p>\n\u003cp>In such cases, even without a positive genetic test, insurers generally don't quibble about covering treatment such as a prophylactic double mastectomy if that's what the woman decides she wants to do, he said.\u003c/p>\n\u003cp>But sometimes a woman's family history will indicate the possibility that she has a different, rarer inherited mutation that increases the likelihood of developing breast and other cancers.\u003c/p>\n\u003cp>For example, \u003ca href=\"http://ghr.nlm.nih.gov/condition/li-fraumeni-syndrome\">Li-Fraumeni syndrome\u003c/a>, caused by a mutation on the TP53 gene, is often associated with an increased risk of breast cancer and sarcomas, cancers of the bones or connective tissues, said Mary Daly, chair of the department of clinical genetics at Fox Chase Cancer Center in Philadelphia. Likewise, Cowden syndrome, associated with a mutation on the PTEN gene, increases the risk of breast and thyroid tumors.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Even though genetic tests are available for these rarer breast cancer syndromes, \"they often aren't covered by insurance,\" she said.\u003c/p>\n\n","blocks":[],"excerpt":"When it comes to inherited genetic mutations that increase the risk of breast cancer, BRCA1 and BRCA2 get nearly all the attention.\r\n\r\nInherited mutations in these genes cause from 5 to 10 percent of breast cancers as well as up to 15 percent of ovarian cancers, according to the National Cancer Institute.\r\n\r\nThere are other, rarer genetic mutations that also predispose women to breast cancer.","status":"publish","parent":0,"modified":1369932340,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":18,"wordCount":603},"headData":{"title":"Insurers Balk at Some Rare Genetic Tests for Breast Cancer | KQED","description":"When it comes to inherited genetic mutations that increase the risk of breast cancer, BRCA1 and BRCA2 get nearly all the attention.\r\n\r\nInherited mutations in these genes cause from 5 to 10 percent of breast cancers as well as up to 15 percent of ovarian cancers, according to the National Cancer Institute.\r\n\r\nThere are other, rarer genetic mutations that also predispose women to breast cancer.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Insurers Balk at Some Rare Genetic Tests for Breast Cancer","datePublished":"2013-05-28T17:28:44.000Z","dateModified":"2013-05-30T16:45:40.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"12988 http://blogs.kqed.org/stateofhealth/?p=12988","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/05/28/insurers-balk-at-some-rare-genetic-tests-for-breast-cancer/","disqusTitle":"Insurers Balk at Some Rare Genetic Tests for Breast Cancer","path":"/stateofhealth/12988/insurers-balk-at-some-rare-genetic-tests-for-breast-cancer","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cstrong>By Michelle Andrews for \u003ca href=\"http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2013/052813-Michelle-Andrews-on-breast-cancer-care.aspx\" target=\"_blank\">Kaiser Health News\u003c/a> and \u003ca href=\"http://www.npr.org/blogs/health/2013/05/28/186885334/insurers-balk-on-rarer-genetic-tests-for-breast-cancer\" target=\"_blank\">NPR\u003c/a>\u003c/strong>\u003c/p>\n\u003cfigure id=\"attachment_12992\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://www.flickr.com/photos/gageskidmore/4840431698/\">\u003cimg class=\"size-large wp-image-12992 \" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/AngelinaJolie_GageSkidmore_Flickr-620x413.jpg\" alt=\"Angelina Jolie's decision to have a double mastectomy after genetic testing has prompted a discussion about which other tests should be covered. (Gage Skidmore/Flickr)\" width=\"620\" height=\"413\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Angelina Jolie's decision to have a double mastectomy after genetic testing has prompted a discussion about which other tests should be covered. (Gage Skidmore/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>When it comes to inherited genetic mutations that increase the risk of breast cancer,\u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/05/15/whats-a-brca-gene-anyway-angelina-jolie/\" target=\"_blank\"> BRCA1 and BRCA2 \u003c/a>get nearly all the attention.\u003c/p>\n\u003cp>Inherited mutations in these genes \u003ca href=\"http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA\" target=\"_blank\">cause from 5 to 10 percent\u003c/a> of breast cancers as well as up to 15 percent of ovarian cancers, according to the National Cancer Institute.\u003c/p>\n\u003cp>There are other, rarer genetic mutations that also predispose women to breast cancer.\u003c/p>\n\u003caside class=\"pullquote alignleft\">Other genes besides BRCA1 and BRCA2 may have mutations that predispose a woman to breast cancer.\u003c/aside>\n\u003cp>Health insurers that cover BRCA-related testing and treatment without a hitch sometimes balk at providing coverage in these other instances. The predictive value of some of those variations isn't always as strong or clear-cut.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>When Angelie Jolie \u003ca href=\"http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html\" target=\"_blank\">said earlier this month\u003c/a> that she'd tested positive for a particularly harmful BRCA1 mutation and had a double mastectomy to substantially reduce her risk of getting breast cancer, she didn't mention her insurance coverage.\u003c!--more-->\u003c/p>\n\u003cp>But many health insurance plans \u003ca href=\"http://www.kaiserhealthnews.org/Features/Insuring-Your-Health/2013/052813-Michelle-Andrews-on-breast-cancer-care.aspx\" target=\"_blank\">routinely cover\u003c/a> genetic counseling and testing if a woman has a family history of breast or ovarian cancer. This is particularly true when there's a pattern of early breast cancer, with diagnoses of family members in their 40s, long before the mid-60s when most women develop the disease.\u003c/p>\n\u003cp>Under President Obama's Affordable Care Act, health plans that weren't grandfathered \u003ca href=\"http://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/aca_implementation_faqs12.html\" target=\"_blank\">must cover genetic counseling and testing\u003c/a> in such women without requiring them to pay anything out of pocket for it.\u003c/p>\n\u003cp>Counseling can cost several hundred dollars, and the genetic test costs roughly $3,000. (The high cost is in part because one company, Myriad Genetics, holds the patent on the BRCA1 and BRCA2 genes. That patent has been challenged and is\u003ca href=\"http://science.kqed.org/quest/audio/bay-area-biotech-industry-braces-for-gene-patenting-court-case/\" target=\"_blank\"> currently under review \u003c/a>by the U.S. Supreme Court.)\u003c/p>\n\u003cp>But other genes besides BRCA1 and BRCA2 might have mutations that predispose a woman to breast cancer. Even though women may test negative for BRCA1 and BRCA2 mutations, some women's history clearly indicates a familial link.\u003c/p>\n\u003cp>\"These women come from families where breast cancer has been marching through the family in young women, with women in their 40s being diagnosed with breast cancer,\" said Stephen Edge, the medical director of the breast center at Roswell Park Cancer Institute in Buffalo, N.Y.\u003c/p>\n\u003cp>These women may well have inherited other genetic mutations, probably related to complex interactions with other genes, that haven't yet been identified, said Edge.\u003c/p>\n\u003cp>In such cases, even without a positive genetic test, insurers generally don't quibble about covering treatment such as a prophylactic double mastectomy if that's what the woman decides she wants to do, he said.\u003c/p>\n\u003cp>But sometimes a woman's family history will indicate the possibility that she has a different, rarer inherited mutation that increases the likelihood of developing breast and other cancers.\u003c/p>\n\u003cp>For example, \u003ca href=\"http://ghr.nlm.nih.gov/condition/li-fraumeni-syndrome\">Li-Fraumeni syndrome\u003c/a>, caused by a mutation on the TP53 gene, is often associated with an increased risk of breast cancer and sarcomas, cancers of the bones or connective tissues, said Mary Daly, chair of the department of clinical genetics at Fox Chase Cancer Center in Philadelphia. Likewise, Cowden syndrome, associated with a mutation on the PTEN gene, increases the risk of breast and thyroid tumors.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Even though genetic tests are available for these rarer breast cancer syndromes, \"they often aren't covered by insurance,\" she said.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/12988/insurers-balk-at-some-rare-genetic-tests-for-breast-cancer","authors":["8344"],"categories":["stateofhealth_14"],"tags":["stateofhealth_518","stateofhealth_46"],"featImg":"stateofhealth_12992","label":"stateofhealth"},"stateofhealth_12765":{"type":"posts","id":"stateofhealth_12765","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"12765","score":null,"sort":[1368664783000]},"guestAuthors":[],"slug":"whats-a-brca-gene-anyway-angelina-jolie","title":"What's a BRCA Gene Anyway?","publishDate":1368664783,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_12777\" class=\"wp-caption aligncenter\" style=\"max-width: 432px\">\u003ca href=\"http://www.flickr.com/photos/gageskidmore/4839882457/\">\u003cimg class=\"size-full wp-image-12777\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/BRCA_AngelinaJolie.jpg\" alt=\"(Gage Skidmore/Flickr)\" width=\"432\" height=\"386\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/05/BRCA_AngelinaJolie.jpg 432w, https://ww2.kqed.org/app/uploads/sites/27/2013/05/BRCA_AngelinaJolie-400x357.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/05/BRCA_AngelinaJolie-320x286.jpg 320w\" sizes=\"(max-width: 432px) 100vw, 432px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Gage Skidmore/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>The first thing you need to know about the BRCA gene is that you have it.\u003c/p>\n\u003cp>Don't panic. Everyone does. In fact, we all have two of them -- the BRCA1 and 2 genes. They are normal genes that \"have an important function in the cell. They are involved in repairing DNA damage,\" explained Dr. Robert Nussbaum, a medical geneticist at UCSF. \"When they're functioning normally, they do a good job for us.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">We all have two copies of the BRCA genes. Men, too.\u003c/aside>\n\u003cp>The problem is what happens when they don't function normally. We'll get to that in a minute. But first, in our call, Nussbaum gave me a helpful primer in basic genetics.\u003c/p>\n\u003cp>For starters, we all have two copies of each of the BRCA genes. Men, too. We get one copy from each parent. These genes are \"like sentences,\" Nussbaum said. \"They are made up of words.\" When they're spelled right, all is well.\u003c/p>\n\u003cp>But \"you can have all kinds of misspellings,\" Nussbaum said. \"Red becomes reed. All kinds of things can happen that will alter the meaning of that sentence.\"\u003c!--more-->\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>If you've ever texted or sent an email or written anything on a computer, you know that there are misspellings that don't change the meaning of what you're trying to say. Nussbaum used the example of \"gray\" and \"grey\". The change in spelling does not change the meaning.\u003c/p>\n\u003cp>With the BRCA genes, there are \"thousands\" of ways the gene can be misspelled, Nussbaum said. But just like gray/grey doesn't matter, neither do many of those BRCA misspellings or what Angelina Jolie correctly called a mutation.\u003c/p>\n\u003cp>Then there are the ones that do matter. Sadly, they matter way too much. On Tuesday Angelina Jolie said \u003ca href=\"http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html?_r=0\" target=\"_blank\">she had a mutation\u003c/a> that gave her an 87 percent risk of developing breast cancer, which is why she decided to undergo a preventive double mastectomy.\u003c/p>\n\u003cp>In general, women who have inherited the harmful mutations have about\u003ca href=\"http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA\" target=\"_blank\"> 60 percent risk\u003c/a> of developing breast cancer over their lifetimes, according to the National Cancer Institute. They are also at much higher risk of ovarian cancer. And men who inherit the gene have a dramatically increased risk of male breast cancer as well as pancreatic and prostate cancers.\u003c/p>\n\u003cp>Still, only about 10 percent of all breast cancers are associated with these mutations. Or, to put it the opposite way, roughly 90 percent of all breast cancers are not related to BRCA mutations. They just happen, for reasons doctors and scientists cannot fully explain.\u003c/p>\n\u003cp>I just googled \"Angelina Jolie\" and \"mastectomy\" and got 736 million results. It's probably safe to say countless women are thinking about BRCA testing right now. But before you run to a lab, Nussbaum said they start with an \"accurate and complete\" family history, including on the father's side. Remember that you get one copy of all your genes, including the BRCA1 and 2 genes, from your dad.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>While \"thousands\" of mutations cause harm and \"thousands\" more have no effect at all, Nussbaum then pointed to a third category, \"variance of uncertain significance,\" he said. Doctors see the mutation, but cannot determine if it damages the gene's function or not. \"So there is no such thing as 'the BRCA1 mutation.' There are thousands. Some are deleterious. Some are not. Some we don't know.\"\u003c/p>\n\n","blocks":[],"excerpt":"The first thing you need to know about the BRCA gene is that you have it.\r\n\r\nDon't panic. Everyone does. In fact, we all have two of them -- the BRCA1 and 2 genes. They are normal genes that \"have an important function in the cell. They are involved in repairing DNA damage,\" explained Dr. Robert Nussbaum, a medical geneticist at UCSF. \"When they're functioning normally, they do a good job for us.\"","status":"publish","parent":0,"modified":1368729694,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":14,"wordCount":573},"headData":{"title":"What's a BRCA Gene Anyway? | KQED","description":"The first thing you need to know about the BRCA gene is that you have it.\r\n\r\nDon't panic. Everyone does. In fact, we all have two of them -- the BRCA1 and 2 genes. They are normal genes that "have an important function in the cell. They are involved in repairing DNA damage," explained Dr. Robert Nussbaum, a medical geneticist at UCSF. "When they're functioning normally, they do a good job for us."","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"What's a BRCA Gene Anyway?","datePublished":"2013-05-16T00:39:43.000Z","dateModified":"2013-05-16T18:41:34.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"12765 http://blogs.kqed.org/stateofhealth/?p=12765","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/05/15/whats-a-brca-gene-anyway-angelina-jolie/","disqusTitle":"What's a BRCA Gene Anyway?","path":"/stateofhealth/12765/whats-a-brca-gene-anyway-angelina-jolie","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_12777\" class=\"wp-caption aligncenter\" style=\"max-width: 432px\">\u003ca href=\"http://www.flickr.com/photos/gageskidmore/4839882457/\">\u003cimg class=\"size-full wp-image-12777\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/BRCA_AngelinaJolie.jpg\" alt=\"(Gage Skidmore/Flickr)\" width=\"432\" height=\"386\" srcset=\"https://ww2.kqed.org/app/uploads/sites/27/2013/05/BRCA_AngelinaJolie.jpg 432w, https://ww2.kqed.org/app/uploads/sites/27/2013/05/BRCA_AngelinaJolie-400x357.jpg 400w, https://ww2.kqed.org/app/uploads/sites/27/2013/05/BRCA_AngelinaJolie-320x286.jpg 320w\" sizes=\"(max-width: 432px) 100vw, 432px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Gage Skidmore/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>The first thing you need to know about the BRCA gene is that you have it.\u003c/p>\n\u003cp>Don't panic. Everyone does. In fact, we all have two of them -- the BRCA1 and 2 genes. They are normal genes that \"have an important function in the cell. They are involved in repairing DNA damage,\" explained Dr. Robert Nussbaum, a medical geneticist at UCSF. \"When they're functioning normally, they do a good job for us.\"\u003c/p>\n\u003caside class=\"pullquote alignleft\">We all have two copies of the BRCA genes. Men, too.\u003c/aside>\n\u003cp>The problem is what happens when they don't function normally. We'll get to that in a minute. But first, in our call, Nussbaum gave me a helpful primer in basic genetics.\u003c/p>\n\u003cp>For starters, we all have two copies of each of the BRCA genes. Men, too. We get one copy from each parent. These genes are \"like sentences,\" Nussbaum said. \"They are made up of words.\" When they're spelled right, all is well.\u003c/p>\n\u003cp>But \"you can have all kinds of misspellings,\" Nussbaum said. \"Red becomes reed. All kinds of things can happen that will alter the meaning of that sentence.\"\u003c!--more-->\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>If you've ever texted or sent an email or written anything on a computer, you know that there are misspellings that don't change the meaning of what you're trying to say. Nussbaum used the example of \"gray\" and \"grey\". The change in spelling does not change the meaning.\u003c/p>\n\u003cp>With the BRCA genes, there are \"thousands\" of ways the gene can be misspelled, Nussbaum said. But just like gray/grey doesn't matter, neither do many of those BRCA misspellings or what Angelina Jolie correctly called a mutation.\u003c/p>\n\u003cp>Then there are the ones that do matter. Sadly, they matter way too much. On Tuesday Angelina Jolie said \u003ca href=\"http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html?_r=0\" target=\"_blank\">she had a mutation\u003c/a> that gave her an 87 percent risk of developing breast cancer, which is why she decided to undergo a preventive double mastectomy.\u003c/p>\n\u003cp>In general, women who have inherited the harmful mutations have about\u003ca href=\"http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA\" target=\"_blank\"> 60 percent risk\u003c/a> of developing breast cancer over their lifetimes, according to the National Cancer Institute. They are also at much higher risk of ovarian cancer. And men who inherit the gene have a dramatically increased risk of male breast cancer as well as pancreatic and prostate cancers.\u003c/p>\n\u003cp>Still, only about 10 percent of all breast cancers are associated with these mutations. Or, to put it the opposite way, roughly 90 percent of all breast cancers are not related to BRCA mutations. They just happen, for reasons doctors and scientists cannot fully explain.\u003c/p>\n\u003cp>I just googled \"Angelina Jolie\" and \"mastectomy\" and got 736 million results. It's probably safe to say countless women are thinking about BRCA testing right now. But before you run to a lab, Nussbaum said they start with an \"accurate and complete\" family history, including on the father's side. Remember that you get one copy of all your genes, including the BRCA1 and 2 genes, from your dad.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>While \"thousands\" of mutations cause harm and \"thousands\" more have no effect at all, Nussbaum then pointed to a third category, \"variance of uncertain significance,\" he said. Doctors see the mutation, but cannot determine if it damages the gene's function or not. \"So there is no such thing as 'the BRCA1 mutation.' There are thousands. Some are deleterious. Some are not. Some we don't know.\"\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/12765/whats-a-brca-gene-anyway-angelina-jolie","authors":["240"],"categories":["stateofhealth_12"],"tags":["stateofhealth_518","stateofhealth_46","stateofhealth_461"],"featImg":"stateofhealth_12777","label":"stateofhealth"},"stateofhealth_12706":{"type":"posts","id":"stateofhealth_12706","meta":{"index":"posts_1591205157","site":"stateofhealth","id":"12706","score":null,"sort":[1368559320000]},"guestAuthors":[],"slug":"why-angelina-jolies-medical-choice-is-likely-not-yours","title":"Why Angelina Jolie's 'Medical Choice' Is Likely Not Yours ","publishDate":1368559320,"format":"aside","headTitle":"State of Health | KQED News","labelTerm":{"site":"stateofhealth"},"content":"\u003cfigure id=\"attachment_12715\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://www.flickr.com/photos/foreignoffice/7296732418/\">\u003cimg class=\"size-large wp-image-12715\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/angelinajolie_foreignandcommonwealthoffice-620x603.jpg\" alt=\"(Foreign and Commonwealth Office/Flickr)\" width=\"620\" height=\"603\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Foreign and Commonwealth Office/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Angelina Jolie lit up social media Tuesday morning with her announcement that she recently had a preventive double mastectomy. She took this route, she says, because she carries a specific BRCA1 mutation -- putting her at an 87 percent risk of developing breast cancer and a 50 percent risk of ovarian cancer. You can read everything about her history in her New York Times piece, \"\u003ca href=\"http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html\" target=\"_blank\">My Medical Choice\u003c/a>.\"\u003c/p>\n\u003cp>But the key here is a\u003cem> specific\u003c/em> BRCA1 mutation. There are many different mutations that can occur in the BRCA gene. Jolie is very careful to walk through all her personal decisions stemming from her unusually high risk, but emphasizes that \"the risk is different in the case of each woman.\"\u003c/p>\n\u003cp>About \u003ca href=\"http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA\" target=\"_blank\">10 percent\u003c/a> of all breast cancers are due to those many BRCA mutations. Dr. Otis Brawley, chief medical officer with the American Cancer Society, \u003ca href=\"http://acspressroom.wordpress.com/2013/05/14/jolie/\" target=\"_blank\">explains in more detail\u003c/a> what individual women should consider, in a response to Jolie's piece:\u003c/p>\n\u003cblockquote>\u003cp>This does not mean every woman needs a blood test to determine their genetic risk for breast and/or ovarian cancer. What it does mean is women should know their cancer family history and discuss it with their regular provider. If appropriate, they should be referred to and have the opportunity to discuss their risk and their options with a genetic specialist.\u003c!--more-->\u003c/p>\n\u003cp>Insurance plans created before the passage of the Affordable Care Act are not required to cover the costs of genetic counseling, testing, and any surgery to reduce the risk of breast cancer. Under the Affordable Care Act, new plans are required to cover the costs of counseling and testing for breast cancer risk. There is no such mandate for the coverage of surgery.\u003c/p>\n\u003cp>A prophylactic (preventive) mastectomy, removing both breasts before cancer is diagnosed, can greatly reduce the risk of breast cancer, by as much as 97%. It does not completely prevent breast cancer because even a very careful surgeon will leave behind a small amount of breast tissue, which can go on to become cancerous.\u003c/p>\n\u003cp>Women with BRCA mutations associated with a high risk of breast cancer, confirmed by testing, and with a strong family history of breast cancer, a previous breast cancer, and who show signs of certain pre-cancerous conditions are among those who could benefit from the surgery. A woman with a mutation of known significance must consider her quantifiable risk in making the very personal decision to have her breasts and ovaries removed or pursuing other options, such as more extensive screening for breast and ovarian cancer.\u003c/p>\n\u003cp>Experts recommend women proceed cautiously, and receive a second opinion before deciding to have this surgery. The American Cancer Society Board of Directors has stated that 'only very strong clinical and/or pathologic indications warrant doing this type of preventive operation.' Nonetheless, after careful consideration, this might be the right choice for some women.\u003c/p>\u003c/blockquote>\n\u003cp>For some women, yes. But, while mutations in the BRCA genes are fairly rare, the majority of women opting for preventive mastectomy are not at elevated risk, as \u003ca href=\"http://www.npr.org/blogs/health/2013/05/14/183892507/angelina-jolie-and-the-rise-of-preventive-mastectomies\" target=\"_blank\">NPR's Shots blog notes\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>\"We found that women who have cancer in one breast overestimate their risk of cancer in the other breast by sixfold,\" says \u003ca href=\"http://www.surg.umn.edu/Faculty_Alpha/tuttle_todd_m/home.html\">Todd Tuttle\u003c/a>, chief of surgical oncology at the University of Minnesota. \"It's very exaggerated.\" ...\u003c/p>\n\u003cp>Increased awareness of breast cancer due to the ubiquitous pink ribbon campaigns could be fueling the rise in prophylactic mastectomies, some people say. \"Women have this exaggerated perceived risk of getting breast cancer,\" Tuttle told Shots. \"They see breast cancer everywhere.\"\u003c/p>\n\u003cp>There has not been an increase in prophylactic mastectomy in Europe, Tuttle notes, though women there have access to the same surgery and reconstruction. \"I wonder if part of the difference is this hyperawareness of breast cancer.\"\u003c/p>\u003c/blockquote>\n\u003cp>Berkeley-based journalist Peggy Orenstein \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/26/berkeley-journalist-takes-on-the-feel-good-war-on-breast-cancer/\" target=\"_blank\">took on the hyperawareness\u003c/a> of breast cancer in another New York Times venue, its Sunday magazine. Orenstein was first diagnosed with breast cancer 16 years ago. She had a lumpectomy plus radiation, then suffered a recurrence last year. Her only option was mastectomy, which she had on the affected breast. Yet she opted against preventive mastectomy on the other side. \u003ca href=\"http://www.nytimes.com/2013/04/28/magazine/our-feel-good-war-on-breast-cancer.html?pagewanted=all&_r=0\" target=\"_blank\">From her article\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>My first instinct this round was to have my other breast removed as well — I never wanted to go through this again. My oncologist argued against it. The tamoxifen would lower my risk of future disease to that of an average woman, he said. Would an average woman cut off her breasts? I could have preventive surgery if I wanted to, he added, but it would be a psychological decision, not a medical one.\u003c/p>\n\u003cp>I weighed the options as my hospital date approached. Average risk, after all, is not zero. Could I live with that? Part of me still wanted to extinguish all threat. I have a 9-year-old daughter; I would do anything — I need to do \u003cem>everything\u003c/em> — to keep from dying. Yet, if death was the issue, the greatest danger wasn’t my other breast. It is that, despite treatment and a good prognosis, the cancer I’ve already had has metastasized. Preventive mastectomy wouldn’t change that; nor would it entirely eliminate the possibility of new disease, because there’s always some tissue left behind.\u003c/p>\n\u003cp>What did doing “everything” mean, anyway? There are days when I skip sunscreen. I don’t exercise as much as I should. I haven’t given up aged Gouda despite my latest cholesterol count; I don’t get enough calcium. And, oh, yeah, my house is six blocks from a fault line. Is living with a certain amount of breast-cancer risk really so different? I decided to take my doctor’s advice, to do only what had to be done.\u003c/p>\u003c/blockquote>\n\u003cp>Meanwhile, at Breast Cancer Action, spokeswoman Angela Wall points out that Jolie had access to \"all the information she needs.\" But in the interest of stating the obvious, that is not the case for every woman.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The genetic test for \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/12/breast-cancer-gene-mutations-at-heart-of-supreme-court-case/\" target=\"_blank\">BRCA mutations\u003c/a> is held tightly by Myriad Genetics, so tightly that \u003ca href=\"http://science.kqed.org/quest/audio/bay-area-biotech-industry-braces-for-gene-patenting-court-case/\" target=\"_blank\">a case questioning whether human genes are patentabl\u003c/a>e has made it the U.S. Supreme Court. Wall says that laboratories across the country could offer a comparable test for a fraction of the cost -- potentially opening up the test to more women -- but Myriad will not license it, making its $3,000 test a monopoly.\u003c/p>\n\u003cp>While Wall is supportive of Jolie's decision (\"This is an impossible decision and women do not make this choice lightly\"), she says the answer to breast cancer is not prophylactic mastectomy, it's prevention.\u003c/p>\n\u003cp>\"It we want to get really serious about preventing breast cancer,\" she practically fumed over the phone, \"we need to do a lot more than celebrating a woman who has preventive mastectomy. ... What about all the other risk factors? The environmental risk factors?\" She advocates that what is needed are strong regulations to limit or ban known toxins that cause breast cancer.\u003c/p>\n\u003cp>\u003cstrong>Learn more:\u003c/strong>\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003ca href=\"http://health.clevelandclinic.org/2012/10/breast-cancer-do-your-genes-put-you-at-risk/?utm_campaign=cc+tweets&utm_medium=social&utm_source=twitter&utm_content=130514+breast+cancer+genes&dynid=twitter-_-cc+tweets-_-social-_-social-_-130514+breast+cancer+genes\" target=\"_blank\">Breast Cancer -- Do Your Genes Put You At Risk? \u003c/a>(Cleveland Clinic)\u003c/p>\n\n","blocks":[],"excerpt":"Angelina Jolie lit up social media Tuesday morning with her announcement that she recently had a preventive double mastectomy. She took this route, she says, because she carries a specific BRCA1 mutation -- putting her at an 87 percent risk of developing breast cancer and a 50 percent risk of ovarian cancer. You can read everything about her history in her New York Times op-ed piece.\r\n\r\nBut the key here is a specific BRCA1 mutation. There are many different mutations that can occur in the BRCA gene. Jolile is very careful to walk through all her personal decisions stemming from her unusually high risk but qualifies that \"the risk is different in the case of each woman.\"","status":"publish","parent":0,"modified":1371247216,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":1200},"headData":{"title":"Why Angelina Jolie's 'Medical Choice' Is Likely Not Yours | KQED","description":"Angelina Jolie lit up social media Tuesday morning with her announcement that she recently had a preventive double mastectomy. She took this route, she says, because she carries a specific BRCA1 mutation -- putting her at an 87 percent risk of developing breast cancer and a 50 percent risk of ovarian cancer. You can read everything about her history in her New York Times op-ed piece.\r\n\r\nBut the key here is a specific BRCA1 mutation. There are many different mutations that can occur in the BRCA gene. Jolile is very careful to walk through all her personal decisions stemming from her unusually high risk but qualifies that "the risk is different in the case of each woman."","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Why Angelina Jolie's 'Medical Choice' Is Likely Not Yours ","datePublished":"2013-05-14T19:22:00.000Z","dateModified":"2013-06-14T22:00:16.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"12706 http://blogs.kqed.org/stateofhealth/?p=12706","disqusUrl":"https://ww2.kqed.org/stateofhealth/2013/05/14/why-angelina-jolies-medical-choice-is-likely-not-yours/","disqusTitle":"Why Angelina Jolie's 'Medical Choice' Is Likely Not Yours ","path":"/stateofhealth/12706/why-angelina-jolies-medical-choice-is-likely-not-yours","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cfigure id=\"attachment_12715\" class=\"wp-caption aligncenter\" style=\"max-width: 620px\">\u003ca href=\"http://www.flickr.com/photos/foreignoffice/7296732418/\">\u003cimg class=\"size-large wp-image-12715\" title=\"\" src=\"http://ww2.kqed.org/stateofhealth/wp-content/uploads/sites/27/2013/05/angelinajolie_foreignandcommonwealthoffice-620x603.jpg\" alt=\"(Foreign and Commonwealth Office/Flickr)\" width=\"620\" height=\"603\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">(Foreign and Commonwealth Office/Flickr)\u003c/figcaption>\u003c/figure>\n\u003cp>Angelina Jolie lit up social media Tuesday morning with her announcement that she recently had a preventive double mastectomy. She took this route, she says, because she carries a specific BRCA1 mutation -- putting her at an 87 percent risk of developing breast cancer and a 50 percent risk of ovarian cancer. You can read everything about her history in her New York Times piece, \"\u003ca href=\"http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html\" target=\"_blank\">My Medical Choice\u003c/a>.\"\u003c/p>\n\u003cp>But the key here is a\u003cem> specific\u003c/em> BRCA1 mutation. There are many different mutations that can occur in the BRCA gene. Jolie is very careful to walk through all her personal decisions stemming from her unusually high risk, but emphasizes that \"the risk is different in the case of each woman.\"\u003c/p>\n\u003cp>About \u003ca href=\"http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA\" target=\"_blank\">10 percent\u003c/a> of all breast cancers are due to those many BRCA mutations. Dr. Otis Brawley, chief medical officer with the American Cancer Society, \u003ca href=\"http://acspressroom.wordpress.com/2013/05/14/jolie/\" target=\"_blank\">explains in more detail\u003c/a> what individual women should consider, in a response to Jolie's piece:\u003c/p>\n\u003cblockquote>\u003cp>This does not mean every woman needs a blood test to determine their genetic risk for breast and/or ovarian cancer. What it does mean is women should know their cancer family history and discuss it with their regular provider. If appropriate, they should be referred to and have the opportunity to discuss their risk and their options with a genetic specialist.\u003c!--more-->\u003c/p>\n\u003cp>Insurance plans created before the passage of the Affordable Care Act are not required to cover the costs of genetic counseling, testing, and any surgery to reduce the risk of breast cancer. Under the Affordable Care Act, new plans are required to cover the costs of counseling and testing for breast cancer risk. There is no such mandate for the coverage of surgery.\u003c/p>\n\u003cp>A prophylactic (preventive) mastectomy, removing both breasts before cancer is diagnosed, can greatly reduce the risk of breast cancer, by as much as 97%. It does not completely prevent breast cancer because even a very careful surgeon will leave behind a small amount of breast tissue, which can go on to become cancerous.\u003c/p>\n\u003cp>Women with BRCA mutations associated with a high risk of breast cancer, confirmed by testing, and with a strong family history of breast cancer, a previous breast cancer, and who show signs of certain pre-cancerous conditions are among those who could benefit from the surgery. A woman with a mutation of known significance must consider her quantifiable risk in making the very personal decision to have her breasts and ovaries removed or pursuing other options, such as more extensive screening for breast and ovarian cancer.\u003c/p>\n\u003cp>Experts recommend women proceed cautiously, and receive a second opinion before deciding to have this surgery. The American Cancer Society Board of Directors has stated that 'only very strong clinical and/or pathologic indications warrant doing this type of preventive operation.' Nonetheless, after careful consideration, this might be the right choice for some women.\u003c/p>\u003c/blockquote>\n\u003cp>For some women, yes. But, while mutations in the BRCA genes are fairly rare, the majority of women opting for preventive mastectomy are not at elevated risk, as \u003ca href=\"http://www.npr.org/blogs/health/2013/05/14/183892507/angelina-jolie-and-the-rise-of-preventive-mastectomies\" target=\"_blank\">NPR's Shots blog notes\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>\"We found that women who have cancer in one breast overestimate their risk of cancer in the other breast by sixfold,\" says \u003ca href=\"http://www.surg.umn.edu/Faculty_Alpha/tuttle_todd_m/home.html\">Todd Tuttle\u003c/a>, chief of surgical oncology at the University of Minnesota. \"It's very exaggerated.\" ...\u003c/p>\n\u003cp>Increased awareness of breast cancer due to the ubiquitous pink ribbon campaigns could be fueling the rise in prophylactic mastectomies, some people say. \"Women have this exaggerated perceived risk of getting breast cancer,\" Tuttle told Shots. \"They see breast cancer everywhere.\"\u003c/p>\n\u003cp>There has not been an increase in prophylactic mastectomy in Europe, Tuttle notes, though women there have access to the same surgery and reconstruction. \"I wonder if part of the difference is this hyperawareness of breast cancer.\"\u003c/p>\u003c/blockquote>\n\u003cp>Berkeley-based journalist Peggy Orenstein \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/26/berkeley-journalist-takes-on-the-feel-good-war-on-breast-cancer/\" target=\"_blank\">took on the hyperawareness\u003c/a> of breast cancer in another New York Times venue, its Sunday magazine. Orenstein was first diagnosed with breast cancer 16 years ago. She had a lumpectomy plus radiation, then suffered a recurrence last year. Her only option was mastectomy, which she had on the affected breast. Yet she opted against preventive mastectomy on the other side. \u003ca href=\"http://www.nytimes.com/2013/04/28/magazine/our-feel-good-war-on-breast-cancer.html?pagewanted=all&_r=0\" target=\"_blank\">From her article\u003c/a>:\u003c/p>\n\u003cblockquote>\u003cp>My first instinct this round was to have my other breast removed as well — I never wanted to go through this again. My oncologist argued against it. The tamoxifen would lower my risk of future disease to that of an average woman, he said. Would an average woman cut off her breasts? I could have preventive surgery if I wanted to, he added, but it would be a psychological decision, not a medical one.\u003c/p>\n\u003cp>I weighed the options as my hospital date approached. Average risk, after all, is not zero. Could I live with that? Part of me still wanted to extinguish all threat. I have a 9-year-old daughter; I would do anything — I need to do \u003cem>everything\u003c/em> — to keep from dying. Yet, if death was the issue, the greatest danger wasn’t my other breast. It is that, despite treatment and a good prognosis, the cancer I’ve already had has metastasized. Preventive mastectomy wouldn’t change that; nor would it entirely eliminate the possibility of new disease, because there’s always some tissue left behind.\u003c/p>\n\u003cp>What did doing “everything” mean, anyway? There are days when I skip sunscreen. I don’t exercise as much as I should. I haven’t given up aged Gouda despite my latest cholesterol count; I don’t get enough calcium. And, oh, yeah, my house is six blocks from a fault line. Is living with a certain amount of breast-cancer risk really so different? I decided to take my doctor’s advice, to do only what had to be done.\u003c/p>\u003c/blockquote>\n\u003cp>Meanwhile, at Breast Cancer Action, spokeswoman Angela Wall points out that Jolie had access to \"all the information she needs.\" But in the interest of stating the obvious, that is not the case for every woman.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The genetic test for \u003ca href=\"http://ww2.kqed.org/stateofhealth/2013/04/12/breast-cancer-gene-mutations-at-heart-of-supreme-court-case/\" target=\"_blank\">BRCA mutations\u003c/a> is held tightly by Myriad Genetics, so tightly that \u003ca href=\"http://science.kqed.org/quest/audio/bay-area-biotech-industry-braces-for-gene-patenting-court-case/\" target=\"_blank\">a case questioning whether human genes are patentabl\u003c/a>e has made it the U.S. Supreme Court. Wall says that laboratories across the country could offer a comparable test for a fraction of the cost -- potentially opening up the test to more women -- but Myriad will not license it, making its $3,000 test a monopoly.\u003c/p>\n\u003cp>While Wall is supportive of Jolie's decision (\"This is an impossible decision and women do not make this choice lightly\"), she says the answer to breast cancer is not prophylactic mastectomy, it's prevention.\u003c/p>\n\u003cp>\"It we want to get really serious about preventing breast cancer,\" she practically fumed over the phone, \"we need to do a lot more than celebrating a woman who has preventive mastectomy. ... What about all the other risk factors? The environmental risk factors?\" She advocates that what is needed are strong regulations to limit or ban known toxins that cause breast cancer.\u003c/p>\n\u003cp>\u003cstrong>Learn more:\u003c/strong>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"http://health.clevelandclinic.org/2012/10/breast-cancer-do-your-genes-put-you-at-risk/?utm_campaign=cc+tweets&utm_medium=social&utm_source=twitter&utm_content=130514+breast+cancer+genes&dynid=twitter-_-cc+tweets-_-social-_-social-_-130514+breast+cancer+genes\" target=\"_blank\">Breast Cancer -- Do Your Genes Put You At Risk? \u003c/a>(Cleveland Clinic)\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/stateofhealth/12706/why-angelina-jolies-medical-choice-is-likely-not-yours","authors":["240"],"categories":["stateofhealth_12","stateofhealth_13"],"tags":["stateofhealth_518","stateofhealth_46","stateofhealth_461"],"featImg":"stateofhealth_12715","label":"stateofhealth"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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But is this once sleepy suburb ready for them?","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/American-Suburb-Podcast-Tile-703x703-1.jpg","officialWebsiteLink":"/news/series/american-suburb-podcast","meta":{"site":"news","source":"kqed","order":"13"},"link":"/news/series/american-suburb-podcast/","subscribe":{"npr":"https://rpb3r.app.goo.gl/RBrW","apple":"https://itunes.apple.com/WebObjects/MZStore.woa/wa/viewPodcast?mt=2&id=1287748328","tuneIn":"https://tunein.com/radio/American-Suburb-p1086805/","rss":"https://ww2.kqed.org/news/series/american-suburb-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkMzMDExODgxNjA5"}},"baycurious":{"id":"baycurious","title":"Bay Curious","tagline":"Exploring the Bay Area, one question at a time","info":"KQED’s new podcast, Bay Curious, gets to the bottom of the mysteries — both profound and peculiar — that give the Bay Area its unique identity. And we’ll do it with your help! You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. 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