MANATEE -- Although across the country from Hollywood, Manatee County health providers probably get it when someone refers to the "Angelina effect."
The reference is not to Angelina Jolie's charisma as a movie star, but to her decision in 2013 to have a preventive double mastectomy after genetic testing revealed she had inherited a mutant gene called BRCA1 that could cause breast cancer.
Testing for the gene is now available in Manatee County since Blake Medical Center entered into a partnership with a genetic counselling provider.
InformedDNA, a six-year-old St. Petersburg company, has begun providing the option of genetic counseling and risk assessment to all of Blake's breast cancer patients, said Kim LaPlant, manager of Diagnostic Imaging at Bradenton's Blake Medical Center.
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"My doctors estimated that I had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer," Jolie wrote after deciding to have her healthy breasts removed.
Jolie's aggressive decision was prompted, she said, by her knowledge that her mother and grandmother had died of breast cancer.
Her story made more people aware of genetic testing and how doctors can use it to implement either more or less aggressive breast cancer treatment plans, La Plant said.
The hospital's new partnership allows Blake to get accreditation from the National Accreditation Program for Breast Centers, a certification awarded to facilities that offer breast cancer patients all the breast cancer benchmarks, including genetic testing, LaPlant said.
Blake Medical Center requires its physicians to ask their breast cancer patients a handful of screening questions involving their family history, said Sue Janczak, an InformedDNA vice president.
The questions narrow down whether the patient is a candidate for genetic counseling. Although they keep tabs on labs across the nation to find good matches for their clients, InformedDNA is not a lab and does not do the genetic testing.
"We are independent and not tied to any lab," Janczak said.
Roughly 14 percent of breast cancer patients are, like Jolie, found to be candidates for genetic counseling, Janczak added.
"In Angelina's case, she was at risk for breast cancer from both her mother and grandmother," Janczak said.
A Blake staff member, called a "navigator" contacts those deemed to be candidates for BRCA1 genetic testing.
Blake has two paid navigators, one for breast cancer and one for lung cancer, who guide the patient
through various processes, Janczak said.
"Their role is as a communication liaison between the providers and the patient," Janczak said. "The navigator is a huge advocate for the patient, going as far as providing transportation if they can't make it to an appointment."
The navigator will coach the Blake patient on how to enter a family history on InformedDNA's website. From there, an InformedDNA genetic counsellor will contact the navigator who will set up interviews with the patient and family to explain options, including perhaps getting their DNA tested to see if they carry a "faulty" gene.
"The patients go into our on-line portal and provide information regarding family history and other risk factors and that information is analyzed by genetic counsellors and then the patients are counseled and advised whether genetic tests are appropriate," Janczak said.
It can be an emotional moment
Kelly Hall, an InformedDNA vice president, can also rattle off all the facts of how InformedDNA has developed screening tools for physicians and how the online portal works, coaching patients on how to build a family tree of family mortality factors.
But she is at her most absorbing when describing what the counseling actually might mean for a Blake patient already diagnosed with breast cancer, dealing with the scary moment when she learns that, based on her genetic makeup, she might need a more aggressive treatment.
"The role of genetic counseling is to understand what the percentages look like and how it might impact you," Hall said. "We put the choices before you. It's a very in-depth process, including drawing a three-generation history.
"If you do decide to test, we make sure the money is spent on the best test available for you," Hall added. "We also give the patient a lifetime opportunity to check in with us to see if anything has changed because the gene you carry might not be identified yet."
In the coming months, InformedDNA will also begin working with physicians across Manatee County. They will inevitably encounter patients who are at risk and must make tough decisions before cancer is evident, Hall said.
Richard Dymond, Herald reporter, can be reached at 941-745-7072 or contact him via Twitter @RichardDymond.