Angelina Jolie writes on her medical choice to get a Double Mastectomy
The internet has been awash with the news of the all time Hollywood superstar and philanthropist, Angelina Jolie after the New York Times published her own op-ed article contribution. In a riveting and yet simplistic way, she aptly captures the narrow corridor hallway of discovering she has a mutated form of the BRCA1 gene that is notoriously implicated for both Breast Cancer & Ovarian Cancer, and how it culminated in her choice to opt for a Double Mastectomy as prevention.
“MY MOTHER fought cancer for almost a decade and died at 56. She held out long enough to meet the first of her grandchildren and to hold them in her arms. But my other children will never have the chance to know her and experience how loving and gracious she was.”
Those were her opening lines and it is probably best to read her entire piece here. But in a nutshell, here is what it came down to for Angelina as she writes: “My doctors estimated that I had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer, although the risk is different in the case of each woman… Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much I could. I made a decision to have a preventive double mastectomy.”
Is a Double Mastectomy the only way to Prevent Breast Cancer?
THE ANSWER IS: NO.
Just for the sake of clarity, it is important to at least know what is currently understood about how Breast Cancer works. Basic Cancer 101 tells you that Cancer survival is best when caught early, and indeed, modern techniques have been developed to help identify and nip cancer in the board, especially when there is already a family history of cancer. All of these are in addition to the highly recommended monthly Self-Breast Examinations and Mammogram for women over 50 years of age.
The chance of having breast cancer is greatly increased when a 1st line female relative has had cancer.
HOWEVER, as classically seen in the case of Breast Cancer, not all of such early identified cases (or even lumps seen on a mammogram) will eventually result in full blown breast cancer in the woman’s life time. And unfortunately, there is no way to tell which/whose will progress or not. This is the dilemma such affected women find themselves in and she alone can ultimately decide on a final decision of watchful waiting, chemoprophylaxis or surgery alongside with the help of her physician.
Just late last year, The Lancet published the findings of an independent panel that reviewed the 25 years old comprehensive UK Breast Screening exercise and their findings raised a possibility of “over-diagnosing breast cancers”. The Cancer Research UK summarized their findings as this:
“For every breast cancer death prevented through screening, about 3 women will have treatment for a cancer that would not have caused them problems. Their doctor would not have known that at the time because they can’t reliably tell which breast cancers are life threatening and which aren’t.”
Of course these were NOT aimed at discrediting the need for early detection nor encourage ignorance but the central idea was for Full Disclosure to help every patient make more INFORMED CHOICES.
Angelina says she decided to disclose this “because I hope that other women can benefit from my experience. Cancer is still a word that strikes fear into people’s hearts, producing a deep sense of powerlessness. But today it is possible to find out through a blood test whether you are highly susceptible to breast and ovarian cancer, and then take action… I want to encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices.”
Not forgetting to highlight the support of her long-standing partner, Brad Pitt, she succinctly reminds the reader that “Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of”.