Jackie Collins Succumbs to Breast Cancer

Author encouraged women to get regular checkups.

Author Jackie Collins, 77, lost a secret battle with breast cancer that she had been waging for the previous six years. Until shortly before her death on September 19, 2015, only her daughters, Rory, Tiffany, and Tracy, knew about her diagnosis.

In an interview with People magazine given only a few days before her death, Collins talked about her illness, explaining why she kept it secret so long and what made her finally go public.

Two years before her diagnosis, Jackie felt a lump in her breast, but convinced herself that "it was benign." After dealing with the deaths of her own mother from breast cancer, husband from prostate cancer, and fiancé from brain cancer, she had become "completely doctor-phobic" and "didn’t want to put pressure on everybody in the family."

It wasn’t until she began limping on a book tour and she had a body scan showing cancer in her bones that she pointed out the breast lump to the doctors.

She was diagnosed with breast cancer that had already metastasized to other parts of her body (Stage 4) and underwent a lumpectomy, radiation therapy, and chemotherapy. Although the drugs gave her some side effects, "they weren’t debilitating," so she was able to keep up with her busy schedule.

One of the reasons Collins did decide to go public was that her daughter Rory, 46, was diagnosed with a Stage 1 breast cancer (a small tumor that hasn’t yet spread to lymph nodes) in May 2015. "[I] couldn’t let Rory fight this battle alone -- I’ve got to come out next to her," she said. "And it might help save other women’s lives." Jackie Collins’s sister, actress Joan Collins, has said that Rory is "completely clear" after chemotherapy.

Asked by People, "What message do you want to share with other women?" Jackie Collins replied:

"Women should get checkups because it really helps to get diagnosed early. I know we’re all told to do it, but some of us are too stupid, and I was one of them. That was my choice … Now I want to tell people it shouldn’t be their choice. I also want to give out the message that stage 4 cancer is a chronic disease, and it’s not a death sentence. You can live a very positive life."

Overview of Breast Cancer

The breast is made up of glands called lobules that can make milk, and thin tubes called ducts that carry the milk from the lobules to the nipple. Breast tissue also contains fat and connective tissue, lymph nodes, and blood vessels.

The most common type of breast cancer is ductal carcinoma, which begins in the cells of the ducts. Breast cancer can also begin in the cells of the lobules and in other tissues in the breast. Invasive breast cancer is breast cancer that has spread from where it began in the ducts or lobules to surrounding tissue.

In the U.S., breast cancer is the second most common cancer in women after skin cancer. It can occur in both men and women, but it is very rare in men. Each year there are about 2,300 new cases of breast cancer in men and about 230,000 new cases in women.

Particular gene mutations associated with breast cancer are more common among certain geographic or ethnic groups, such as people of Ashkenazi (central or eastern European) Jewish heritage and people of Norwegian, Icelandic, or Dutch ancestry.

What Genes are Related to Breast Cancer?

Cancers occur when a buildup of mutations in critical genes—those that control cell growth and division or repair damaged DNA—allow cells to grow and divide uncontrollably to form a tumor. In most cases of breast cancer, these genetic changes are acquired during a person's lifetime and are present only in certain cells in the breast. These changes, which are called somatic mutations, are not inherited. Somatic mutations in many different genes have been found in breast cancer cells.

Less commonly, gene mutations that are present in essentially all of the body's cells increase the risk of developing breast cancer. These genetic changes, which are classified as germline mutations, are usually inherited from a parent. (The term “germline” means that the mutations are present in in a person’s germ cells or gametes, and can therefore be passed between generations.)  In people with germline mutations, changes in other genes, together with environmental and lifestyle factors, also influence whether a person will develop breast cancer.

Some breast cancers that cluster in families are associated with inherited mutations in particular genes, such as BRCA1 or BRCA2. These genes are described as "high penetrance" because they are associated with a high risk of developing breast cancer, ovarian cancer, and several other types of cancer in women who have mutations.

The proteins produced from the BRCA1 and BRCA2 genes are involved in fixing damaged DNA, which helps to maintain the stability of a cell's genetic information. They are described as tumor suppressors because they help keep cells from growing and dividing too fast or in an uncontrolled way. Mutations in these genes impair DNA repair, allowing potentially damaging mutations to persist in DNA. As these defects accumulate, they can trigger cells to grow and divide without control or order to form a tumor.

How Do People Inherit Breast Cancer?

Most cases of breast cancer are not caused by inherited genetic factors. These “sporadic” cancers are associated with somatic mutations in breast cells that are acquired during a person's lifetime, and they do not cluster in families.

In hereditary breast cancer, the way that cancer risk is inherited depends on the gene involved. For example, mutations in the BRCA1 and BRCA2 genes are inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to increase a person's chance of developing cancer. Although breast cancer is more common in women than in men, the mutated gene can be inherited from either the mother or the father.

In many cases of breast cancer that clusters in families, the genetic basis for the disease and the mechanism of inheritance are unclear.

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