Breast Cancer: How Women Won the Right to Know — and What We're About to Lose

Mary-Claire King Opened the Door. Now Dr. Joan Brugge Needs Us to Keep It Open

What We May Lose — Right Now

At Harvard Medical School, Dr. Joan Brugge’s team has identified specific cells in breast tissue that carry the earliest genetic seeds of tumors — present in the apparently healthy breast tissue of every woman they’ve examined. Brugge’s goal: find a way to eliminate those cells before they turn cancerous.

For women who carry the BRCA1 gene, the stakes are especially high. They currently face brutal choices: removing their breasts and ovaries, or suffering the anxiety of taking their chances or undergoing intensive surveillance (which may not be enough to save their lives).

Brugge is working toward a third option.

In August 2026, her funding ends — due to the Trump administration’s freeze on NIH grants to Harvard. Brugge’s $7 million National Cancer Institute grant was restored briefly after a legal battle, but the freeze made renewal impossible — and the administration’s rules absurdly bar her from reapplying now. Seven members of her lab staff are gone. Brugge is no longer accepting job applicants from outside the U.S. — even top candidates — because she cannot afford the Trump administration’s new $100,000 fee on visas for some foreign researchers. She now spends much of her time fundraising instead of doing science.

This is our moment to make noise. Women at risk for breast cancer — and the people who love them — have done it before. Here’s the story of how.

Mary Claire King: Seventeen Years Looking for a Cause

In 1974, a geneticist at the University of California, Berkeley, asked women with breast cancer whether anyone else in their family had it too. Mary-Claire King was looking for a pattern. It took sixteen more years to nail down a major biological cause of familial breast cancer.

At fifteen, King had watched her best friend die of a kidney tumor. "It seemed so unfair," she wrote later. "I said to myself, something needs to be done." Most teenagers who respond that way go on to other things. But King turned her grief into a career of fighting cancer. "It's the little pebbles," she would say, "that make a path."

Her path led, in 1990, to proving that a single gene on Chromosome 17 was responsible for a heritable form of breast and ovarian cancer. The scientific establishment had doubted such a gene existed, claiming breast cancer was too common, too variable to trace to one inherited mutation. King’s data showed otherwise. The gene would come to be called BRCA1.

I’ve written in this series about James Watson and Nancy Wexler, scientists who chose not to learn their own genetic fate because nothing could be done to prevent the diseases they feared.

BRCA1 is different. Women who carry it face dramatically elevated risk for breast and ovarian cancer — but if they know, they can act, though currently what’s required of them is brutal. Still, the knowledge can be lifesaving.

Should Genes Be Patented?

King published her discovery in full detail, making her findings freely available to any scientist prepared to take the research further. Myriad Genetics did exactly that — cloning the gene itself in 1994 and patenting it. For nearly two decades, Myriad held an effective monopoly on BRCA testing in the United States. The price was set at $3,000 to $4,000. Other labs that tried to offer the test received cease-and-desist letters. A second opinion was simply unavailable.

King fought back. She supported the ACLU when it sued Myriad on behalf of patients and researchers, arguing that a naturally occurring gene — something that exists in every human body, discovered but not invented — cannot be owned. In June 2013, the Supreme Court agreed, unanimously.

The monopoly ended. Testing prices fell. More women could afford to probe their genetic risks for this dire disease - if they understood their situation.

The Year Everything Converged

That same year, Angelina Jolie published her New York Times op-ed disclosing that she carried a BRCA1 mutation and had chosen to have a preventive double mastectomy and oophorectomy. Millions of readers who had never heard the term “BRCA” encountered it for the first time. Referrals for genetic counseling and testing rose markedly in the months that followed. Jolie showed the world that a woman can make this choice and remain feminine and attractive.

BRCA testing moved from a narrow clinical niche into mainstream medicine as women asked their doctors for the life-saving test.

King kept pushing. Accepting the Lasker Award in 2014, she argued that BRCA testing should not be limited to women with a strong family history. “Roughly 50% of patients who carry an unambiguously damaging mutation have no close family history,” she noted. Every woman diagnosed with breast cancer who could have been identified beforehand as a carrier was, in King’s words, a missed opportunity for prevention.

And Now?

We have a historic opening to sharply reduce suffering and deaths from breast cancer someday soon, but if we don’t stand up, this momentum likely will be lost for a decade or more. Brugge's lab is not the only one under siege. Breast cancer research across the country has been crippled, and more damage is coming.

The women and men who made noise before — in courtrooms, in op-ed pages, in doctors’ offices — changed countless women’s lives. Now it’s our turn.