Countering the "Angelina effect": New study aims to understand and reduce fear of cancer recurrence

October 27, 2015

Despite a low risk of breast cancer recurrence, increasing numbers of Canadian women are opting to have their healthy breast removed after a cancer diagnosis in their other breast.

With a $100,000 grant from the Canadian Cancer Society, Dr Janet Squires is trying to understand and minimize the "Angelina effect." The "Angelina effect" refers to American actress Angelina Jolie who famously had a preventive double mastectomy after she learned she carried a mutation in the BRCA1 gene known to dramatically increase the risk of breast cancer.

"Our culture, the media and emotions after a breast cancer diagnosis can all be factors in a woman's choice to have her healthy breast removed," says Dr Squires, an assistant professor of nursing at the University of Ottawa and a scientist in the clinical epidemiology program at The Ottawa Hospital. "However, for most women with one-sided breast cancer, the risk of developing cancer in their healthy breast is not higher than the general population."

In addition, a double mastectomy is significantly more risky to the patient than a single breast removal. "Removing the healthy breast means added time under the knife and double the amount of general anesthesia, which puts the patient at a higher risk of cardiovascular and lung complications as well as blood clots as a result of the general anesthetic," says Dr Angel Arnaout, a surgical oncologist and associate scientist with The Ottawa Hospital, assistant professor at the University of Ottawa and study co-principal investigator. Post-surgery, women can experience wound complications, infection and chronic or phantom pain.

With their grant, the researchers will consult with medical professionals across Canada, including surgical oncologists, plastic surgeons, medical and radiation oncologists, as well as women with breast cancer, to find out why women are having healthy breasts removed. Armed with this information, they will develop interventions to reduce the number of unnecessary breast removals. Interventions could include improving the education and information available on risks and side effects of prophylactic mastectomies.

For some women, like Angelina Jolie, who carry a BRCA gene mutation, double mastectomy is a good option. But only about 5% of women with breast cancer carry such gene mutations. The remaining 95% of women have a low risk of getting cancer in their healthy breast.

"This study highlights the importance of clinical care being guided by evidence – more treatment is not always better," says Dr Siân Bevan, Director of Research, Canadian Cancer Society. "With the help of world class research funded by the Canadian Cancer Society, Canadian women will be able to make more informed treatment decisions."

This research is made possible by a $100,000 Knowledge to Action Grant from the Canadian Cancer Society. This year the Society is investing almost $5.5 million in breast cancer research.

About the Canadian Cancer Society
The Canadian Cancer Society funds the best cancer research in Canada, thanks to our generous donors and our rigorous peer-review process. We are the largest national charitable funder of cancer research in Canada, funding hundreds of researchers in universities, hospitals and research centres. Make your gift today at

About The Ottawa Hospital
The Ottawa Hospital is one of Canada’s largest learning and research hospitals with over 1,100 beds, approximately 12,000 staff and an annual budget of over $1.2 billion. Our focus on research and learning helps us develop new and innovative ways to treat patients and improve care. As a multi-campus hospital, affiliated with the University of Ottawa, we deliver specialized care to the Eastern Ontario region, but our techniques and research discoveries are adopted around the world. We engage the community at all levels to support our vision for better patient care.

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