Nautilus

My Family’s Decade in Genetic Limbo

In 2008, my 19-year-old daughter, Danielle, took the same type of DNA test for breast and ovarian cancer that actress Angelina Jolie took recently.

Jolie, 38, came out positive and opted for a preventive double mastectomy to dramatically reduce her risk of breast cancer, a too-often-lethal disease. She based her decision on a telltale pattern of mutations in the BRCA1 gene and a family history of breast cancer that claimed her aunt at age 61 and ovarian cancer that took her mother’s life at 56.

The actress was told she had an 87 percent chance of developing breast cancer and a 50 percent chance of getting ovarian cancer, because of her particularly potent combination of family-illness history and genetics. This risk assessment, however, offered a level of genetic certainty for Jolie that is regrettably rare for most healthy people wanting to know if they have an elevated predisposition for a common disease like breast cancer. Only a few thousand breast-cancer patients in the United States share Jolie’s specific genetic mutations. The rest of the more than 230,000 cases annually diagnosed nationwide are caused by different genes or by other factors that cannot be as accurately predicted.

Danielle was

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