Making the breast decision (2)

Private solutions

Genetic tests are conducted by private institutes instead of hospitals in China. Unlike Jolie's test, which cost about $3,000, many of these institutes offer tests at a fraction of that price.

A staff member surnamed Zou from a biotechnology firm in Beijing told the Global Times that genetic tests for common gynecological diseases including breast cancer cost less than 3,000 yuan ($488.7). He added that inquiries have increased since Jolie's bout with cancer.

"Hospitals rarely conduct these genetic tests as the function of hospitals in China is diagnostic, just to tell you whether you've developed the disease or not," Zou said. "The tests we offer are preventive and typical of scientific research. They're not included in the catalogue the government has mandated for hospitals, so the tests are not really acknowledged by the government."

Zou said that his company had been offering the service for seven years, but none of the customers who found they had faulty genes went on to have mastectomies. Instead, most adjusted their lifestyles to avoid cancer.

"The domestic medical system pushes doctors to discourage people from taking these tests, and even when faulty genes are identified, people have limited awareness of the significance," he said.

While many Chinese doctors prefer to stress breast cancer screenings for early detection, a minority of dissenters agree with Jolie's approach.

Zhang Bin, a breast cancer doctor at the Tianjin Medical Cancer Institute & Hospital, told the Global Times that Jolie's behavior should be recommended in China, based on his 26-week-long clinical training experience in the US.

"It's cruel to wait until people find out they already have cancer," Zhang said. "The process of radiotherapy and chemotherapy following the surgery is torture for patients."

The way forward?

Zhang said that from his experiences, all the women in America who identified these risk factor genes opted for preventative mastectomies. He suggested that doctors should make people aware of the facts so they can decide. Wang echoed Zhang's opinion, saying that the government could certify an institute to offer tests and give people the ability to choose.

Zhang Zhigang, a breast cancer doctor from the Beijing Tianyi Breast Hospital, told the Global Times that China should set up a sample database to figure out the statistics related to risk-factor genes among Chinese.

"It needs government investment," Zhang said. "These genetic tests can be costly. Those with low prices may overlook some key points of mutation and therefore be inaccurate.

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