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BEHIND THE HEADLINES Jewish women and breast cancer: Do special studies really matter?

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NEW YORK, May 20 (JTA) — A new study indicates that people with certain genetic predispositions to breast and ovarian cancers — which have been identified in Jews of Ashkenazi descent — may have a somewhat lower risk of developing those diseases than previously thought. Despite the seemingly good news, the latest study on Jewish women and breast cancer, published last week, has sparked objections among some Jewish women to the focus on the so-called “Jewish genes.” These are the markers for the breast cancer genes BRCA1 and BRCA2. The studies provide no basis of comparison with the general population, they say. Furthermore, they leave women wondering what to do once they find out that they have these mutations. It would be more important, they say, to fund research for a cure for cancer. When the two genetic markers were discovered last year, “suddenly we were singled out” in a way some Jews found disconcerting, said Dale Mintz, a certified health educator and national director of health education for Hadassah, the women’s Zionist organization headquartered in New York. “ There’s nothing really Jewish about this because no other groups have been tested” for the genetic markers for these cancers, said Nancy Kaufman, executive director of the Jewish Community Relations Council of Greater Boston. “Why are we being targeted?” Not everyone shares these concerns, however. “Jews have an understandable wariness and concern” about being singled out for medical research, given the Nazi era when Jews were selected for medical experimentation and extermination, said Lois Waldman, director of the American Jewish Congress’ Commission on Women’s Equality. Nonetheless, Jews are being targeted “for good scientific reasons because it facilitates the research,” Waldman said. She said that by focusing on the relatively small Jewish population, scientists are able to come up with useful data. The latest study into the risk of breast and ovarian cancers among Ashkenazi Jews found that a person with the genetic mutations has a 56 percent of getting breast cancer, and a 17 percent chance of ovarian cancer by the age of 70, no matter what her family history of the diseases. Earlier estimates were that as many as 85 percent of women with the genetic mutation would develop breast cancer, and that 60 percent would develop ovarian cancer by age 70. The genes predisposing a woman to breast cancer are found in as many as 2 percent of the Ashkenazi Jewish population whose ancestors hailed from Eastern or Central Europe. An estimated 8 percent of women in the general U.S. population will develop breast cancer, and 2 percent will likely develop ovarian cancer, according to reporting on the subject. Dr. Jeffrey Streuwing, the chief author of the new National Cancer Institute study, and his colleagues studied 5,318 Jewish women and men in the Washington, D.C., area by taking blood samples at synagogues and Jewish community centers. The scientists analyzed the samples as well as detailed family histories of the volunteers. Other scientists working on studies of breast cancer among Ashkenazi Jews faulted the Streuwing study for relying heavily on family memories of ancestors who may have had breast or ovarian cancer to determine their descendants’ risk of developing the same diseases. The critics, including Dr. Mary-Claire King, who is working on her own study of breast and ovarian cancer risk among 1,000 Jewish women in the New York area, was quoted as saying that relying on the memories of family members is unreliable since cancer was rarely discussed in earlier generations. King was one of the lead investigators in the original research that produced information about the cancer-causing genes in Ashkenazi Jews. Streuwing’s was one of four studies on breast cancer whose results were published in the New England Journal of Medicine last week. He was not available for an interview. The studies have drawn considerable attention in the Jewish community. Both Hadassah and the AJCongress’ Commission on Women’s Equality have held seminars on the issue. In Boston, some 800 people attended a meeting at a Boston synagogue in January to address concerns over the news of the first study, Kaufman said. That meeting gave way to a Boston Jewish Women’s Breast Cancer Coalition, which now meets monthly. Many women of Ashkenazi descent were being told by their doctors that if they have a family history of breast or ovarian cancer, they should be tested. “The concern is once they’re tested, then what? The `what’ is not clear yet,” she said. Some are concerned that there will be a rush of women seeking prophylactic removal of their breasts and ovaries. Those radical procedures, according to another study published at the same time as Streuwing’s in the New England Journal of Medicine, reduce the risk of developing breast cancer by 85 percent and the risk of developing ovarian cancer by 50 percent. What everyone in the Jewish community does seem to agree on is that there needs to be some guarantee that information from genetic testing for breast and ovarian cancers, or other diseases, will not be used by insurance companies or potential employers to discriminate against carriers. “We really need to protect women from opening them up against that discrimination,” said Hadassah’s Mintz.

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