Would you choose a preventative double mastectomy like Angelina Jolie?

Angelina Jolie announced Tuesday in a New York Times editorial that she had a preventative double mastectomy. She learned she carried a gene that gave her a 87 percent chance to get breast cancer.  Her own mother died at 56 of breast cancer after a 10-year battle.

Here is more from the AP:

“The Oscar-winning actress and partner to Brad Pitt made the announcement in the form of an op-ed she authored for Tuesday’s New York Times (http://nyti.ms/17o4A0f ) under the headline, “My Medical Choice.” She writes that between early February and late April she completed three months of surgical procedures to remove both breasts.

“Jolie, 37, writes that she made the choice with thoughts of her six children after watching her own mother, actress Marcheline Bertrand, die too young from cancer.

“My mother fought cancer for almost a decade and died at 56,” Jolie writes. “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.”

“She writes that, “They have asked if the same could happen to me.”

“Jolie said that after genetic testing she learned she carries the “faulty” BRCA1 gene and had an 87 percent chance of getting the disease herself.

“She said she has kept the process private so far, but wrote about it with hopes of helping other women.

“I wanted to write this to tell other women that the decision to have a mastectomy was not easy. But it is one I am very happy that I made,” Jolie writes. “My chances of developing breast cancer have dropped from 87 percent to under 5 percent. I can tell my children that they don’t need to fear they will lose me to breast cancer.”

“Phone and email messages left by The Associated Press late Monday night seeking comment from Jolie representatives were not immediately returned.

“She is anything but private in the details she provides, giving a description of the procedures.

“My own process began on Feb. 2 with a procedure known as a ‘nipple delay,’” she writes, “which rules out disease in the breast ducts behind the nipple and draws extra blood flow to the area.”

“She then describes the major surgery two weeks later where breast tissue was removed, saying it felt “like a scene out of a science-fiction film,” then writes that nine weeks later she had a third surgery to reconstruct the breasts and receive implants.”

“Many women have chosen preventive mastectomy since genetic screening for breast cancer was developed, but the move and public announcement is unprecedented from a star so young and widely known as Jolie.

“She briefly addresses the effects of the surgery on the idealized sexuality and iconic womanhood that have fueled her fame.

“I do not feel any less of a woman,” Jolie writes. “I feel empowered that I made a strong choice that in no way diminishes my femininity.”

“She also wrote that Brad Pitt, her partner of eight years, was at the Pink Lotus Breast Center in Southern California for “every minute of the surgeries.”

For any woman it would be a difficult choice to have your own flesh removed, but I think a particularly difficult choice for someone whose career partially relies on her beauty.  I’m glad she knew the importance of being around for family and didn’t let vanity or fear get in the way.  (Although, I’m sure the doctors did a beautiful job on her reconstructed breasts.)

I went for my annual check up around January and they had me fill out a form assessing my risk factor for cancers that are generally hereditary. I came out looking good on the breast cancer. We don’t have it in our family. But I know I am totally screwed on the autoimmune diseases like rheumatoid arthritis. I am waiting for that to hit any day. I still need to get my mammogram for the year. I have the paper work sitting on my desk, and I haven’t had time to do it. I am hoping to get in next week before the kids gets out of school.

If breast cancer runs in your family have you looked into genetic testing? Would you have a preventative double mastectomy? What do you think of Jolie’s decision to do it? What do you think of her decision to share the news? Would her decision influence your decision?

29 comments Add your comment

Mayhem

May 14th, 2013
10:38 am

First off, I heard her mother died of ovarian cancer, not breast cancer (Good Morning America this a.m.)

Second, no celebrity has ANY influence over me and my body. Kudos for Ms. Jolie, but she in no way will influence MY decision.

Unfortunately, I do not know my biological medical history, nor do I know what I have passed on to my kids, as I am adopted. However, if I KNEW there was a high risk for me for breast cancer, then I would consider the surgery.

I do get yearly exams each and every year! I make the rounds around my birthday.

catlady

May 14th, 2013
10:44 am

I might make that choice if I had the same financial resources as she has. I am sure she had the Cadillac of methods used. Not many women have the money/ insurance to get the sort of reconstruction she describes. Good for her in discussing it. Hopeshe continues to do well.

catlady

May 14th, 2013
10:48 am

BTW, my mom had breast cancer after menopause. She didn’t die of it, or from the uterine cancer, either, but from lung cancer. She had been quit for a dozen years, but the seed was planted during the 40 plus years she smoked.

Needabailouttoo!

May 14th, 2013
10:49 am

I’m a daughter of a woman who died of ovarian cancer, and though I haven’t been gene tested, I’ve known how my risk factors are extraordinarily higher of also developing both breast and ovarian cancer due to heredity. The best way to never get cancer is to prevent it. Yes, if I had the money, I would do the same thing as Ms. Jolie has done, no question.

Liliana

May 14th, 2013
11:00 am

I would never choose a preventative double mastectomy but yes to periodical medical checks.

HB

May 14th, 2013
11:00 am

With an 87% chance, yeah, I’d probably do what she did (not sure how $ and insurance would factor in exactly — the surgeries may be more affordable than the almost inevitable cancer). Mayhem, biological history is often a reason why women are gene tested, but you can certainly be tested without knowing your history if you wish.

Techmom

May 14th, 2013
11:11 am

I don’t blame her. Having an 87% chance of getting breast cancer sounds like it’s only a matter of time.

Common Sense

May 14th, 2013
11:18 am

Angeline Jolie has done a huge service – to the failed western medical establishment. She has now made it ok to treat them as gods and to willfully mutilate your body all because western medicine puts absolutely no faith, no research, and no encouragement behind actually discovering the CAUSE of cancer or any means for real prevention.

Cancer is just you gone bad. It is not a foreign invader (although there is research that suggests that certain fungi may play a role, and of course the HPV virus is implicated in a few types of cervical cancer). Ultimately, regardless of the trigger, cancerous cells are just your own cells that have chosen to behave/reproduce, etc. in a manner that is no longer consistent with continued life (if left unchecked). Prior to these changes, these same cells were functioning perfectly well. So what changed or what encouraged the change? It certainly wasn’t a lack of deadly chemotherapy chemicals or radiation. Your body is what has been put into it by you and what it has taken in from the environment.

While western medicine has identified a few chemicals that can be proven to actually CAUSE cells to become cancerous, for most cancers western medicine has no clue whatsoever. I see the statistic she throws out about her chances of getting breast cancer since she has the BRCA1 gene, but what is behind those numbers? Is it really true that 87% of women or men with that gene absolutely will get cancer? Is that worldwide, under every environmental condition, under every type of diet, exercise regime, body weight, sanitary conditions, etc? And what is different in those women/men who have the gene but DON’T get cancer? There is a complete and total difference between correlation and causation (not that the media ever want to educate you to the distinction). There have hundreds of studies that show time and time again that radical changes in lifestyle have the greatest impact on reducing cancer rates, though it would be nearly impossible to positively say that these changes prevented cancer from starting in that they have no real idea what actually causes it. I personally know a women who rejected surgery, chemo, radiation, etc. in favor of radical food and lifestyle changes (but not so radical that everyone couldn’t do them) who beat breast cancer. I know her doctor and he is more than happy to confirm this and her transformation changed the way he practices medicine. They both live here in Atlanta and their businesses now focus on changes in body health as the way to prevent disease – and they are working (naturally). Success stories like these are everywhere if you look beyond the establishment/industry publications. Remember, chemo, radiation, surgery, etc. all combine to deliver hundreds of billion dollars a year to the western medical establishment. Dietary changes do not, and shifts away from processed, pesticide-laden foods, animal products, sugary products, grains, etc. would undermine countless other businesses around the world that count on the embrace of the western diet for their profits. Just follow the embrace of the western diet around the world and you will see a direct correlation with increasing cancer rates (well-documented).

Put an otherwise healthy plant in bad soil with poor water, toxic chemicals, etc. and the plant will eventually develop a fatal disease and die. Why is it so hard to understand that the same is true of human beings or any other species for that matter?

What Angelina Jolie has done is to say that it is better to cut off your breasts to spite yourself and that so long as there is a surgical solution, examining a healthy lifestyle and other preventive measures is not as important. In the end, all that is left is a body devoid of breast tissue that is filled with the same toxins as before. Maybe the fact that so many end up with reoccurring cancers is because they fundamentally never changed the way they were treating their bodies.

squillian

May 14th, 2013
11:32 am

Yes. I chose prophylactic bilateral mastectomies last year. Those of us who test positive for the BRCA1 (like Angelina Jolie) or BRCA2 (like me) mutations know that statistically, the question is WHEN we will be diagnosed with cancer, not if. BRCA positive women are at significantly higher risk for ovarian cancer as well as breast cancer, so the fact that Angelina Jolie’s mother passed from ovarian cancer is probably related to BRCA1 mutation.

Unless/until you’ve stood in our shoes, don’t judge.

Techmom

May 14th, 2013
11:42 am

squillian – If you don’t mind sharing. What made you get tested? Did your mother or other close family members have breast cancer? How old are you?

Anne Onymous

May 14th, 2013
12:06 pm

Honestly, who could possibly say what they “would” do? I’m waiting on results of a breast biopsy and I’ve changed my mind 6 times about what I “would” do if it’s bad news. You just don’t know unless you’re there, and no one should be judged on this deeply personal, emotional decision.

jarvis

May 14th, 2013
12:08 pm

Shame. She had really nice breasts.

iRun

May 14th, 2013
12:25 pm

@ Common Sense: Nobody said 87% of men and women would get breast cancer if they tested positive for the gene. The interpretation of this is that men and women who test positive have an 87% chance of developing breast cancer. That’s super duper high individual odds. As a statistician, if I have those odds I take action. I don’t sit around and wait.

And while you may not be entirely incorrect in your assessment of the cancer problem, it would be completely foolish to wait for the world to change while you die needlessly of this disease. Chopping off a body part to save a life is a way better option than dying and leaving your family to suffer in your absence. This doesn’t mean you can’t advocate for a better prevention of cancer or for better scientific research into causes.

I work in HIV. I would RATHER get HIV than cancer. Cancer is THAT scary.

@Mayhem: I think you’re reading this wrong. Angelina Jolie isn’t trying to influence your decision in the way you probably think. She’s trying to put the issue and it’s stigma on the table. She’s a world renown sex symbol and she’s being completely public about a serious issue that impacts the external and internal perception of female sexuality. For women like me, the question to keep my breasts in order to keep my femininity intact over getting rid of them and living a longer life with my husband and son is a no brainer. I always choose to live. But we don’t live in a world where everyone feels like I do. There are many, many, many women who feel diminished due to the loss of their breasts.

I applaud AJ for essentially declaring “A beautiful woman remains beautiful and alive without her breasts. Her life is better for her presence in it.”

Bgb

May 14th, 2013
12:26 pm

Glad to see that someone at the AJC took the time today to correct some of the grammar errors that commenters pointed out about the 2 blog postings today.

Though it looks like the comments are gone.

Grasshopper

May 14th, 2013
12:28 pm

“Nobody said 87% of men and women would get breast cancer if they tested positive for the gene. The interpretation of this is that men and women who test positive have an 87% chance of developing breast cancer.”

What’s the difference?

Mayhem

May 14th, 2013
12:50 pm

@irun – that was one of the questions TWG posed at the end of the article. I was answering that question. :))

iRun

May 14th, 2013
12:58 pm

@Mayhem – oh right. Theresa puts a lot of off the cuff questions on the backend of her posts and I sometimes gloss them together. Still, I think she means the public health form of that question “Do you think a public figure or celebrity bringing awareness to this issue will help to women feel more comfortable making this sobering decision?”

iRun

May 14th, 2013
1:00 pm

So, my explanation to Grasshopper is caught in the interwebs. I hope it gets released because I don’t want to retype it all!

squillian

May 14th, 2013
1:05 pm

Techmom (and I am also a Techmom): I was tested because my father’s family history is Eastern European Jewish. My father was diagnosed with breast cancer 5 years ago. His half sister was diagnosed with breast cancer 2 years ago. Their cousin was diagnosed with a very aggressive form of uterine cancer this year. Cousin’s father passed from pancreatic cancer in 1985. I am 44 years old, and tested last year.

Techmom

May 14th, 2013
1:52 pm

squilian – wow, cancer has certainly taken an awful toll on your family. I don’t blame you for being proactive.

My son is in Scouts and as a leader I have been teaching the Physical Fitness merit badge to his troop. We were discussing cancer last week and one of the things I brought up was that men can get breast cancer too. There were quite a few shocked looks in the room.

K's Mom

May 14th, 2013
2:16 pm

I just do not think there is any way to know what you would do unless you are faced with this situation. I have two friends who had radical double mastectomies at the ages of 27 and 35 because of confirmed cancer. Both had mothers who had been treated and I do not think they could answer that question even given what they know now. Both dealt with body image issues along with fighting cancer and both have had further medical issues. I think the best thing that Guiliana Rancic and Angelina Jolie have done for women who have mastectomies at young ages is make other women aware that they are still beautiful with or without the breasts they were born with. I think they both have made a strong case for rocking reconstruction and it is my understanding that insurance has to cover reconstruction based on the experience of my two friends. The other thing that these two women have done is openly talk about this as it relates to their partnerships with their husbands/partners. I think Bill Rancic and Brad Pitt talking about their wives being beautiful post surgery helps men deal with the changes that their wives are going through and may help to support the emotional toll their wives face as well.

I had a hysterectomy (uterus only) in December at 38 due to all sorts of female issues. Even though no one can look at me and tell that anything is different, I went through several months of body issues and feeling strange in my own skin. I can 100% understand how a young woman or any woman who loses her breasts would have to learn to live in their new body. What Angelina Jolie has done is give a voice to something that often times women struggle with alone.

Brown Eyed Girl!

May 14th, 2013
2:18 pm

I don’t know what I would do If I was in that situation, but I would hope I wouldn’t get judged so harshly for making a decision about my life and my family. I had breast reduction surgery several years ago because my second pregnancy gave me something my body was never meant to have. My 4′11 body grew 38 F breast that never went away. Hormones put them there and no amount of exercise was going to take them away. I had pain in my shoulders and had to wear multiple bras at one time to keep them in place. I couldn’t even run with my kids. I did find out one of the benefits of having the surgery was a reduction in my chances for breast cancer. I believe if I did make that decision, I wouldn’t regret it and my husband would support me!

GTT

May 14th, 2013
3:15 pm

It’s preventive, not preventative.

Common Sense

May 14th, 2013
3:35 pm

Brown Eyed Girl – Your breast reduction surgery was for a significant immediate health issue. I work with someone who had the same surgery and you can see it in her eyes that her life has been changed for the positive. That is quite different from removing your breasts entirely before having tried any of a number of well-documented changes in lifestyle that are proven to create an environment of health in the patient.

And I really don’t understand the previous comment about waiting for the world to change. The only thing that has to change is you and your diet/health. She is saying that surgery is preferred over that.

Denise

May 14th, 2013
5:55 pm

We have had lots of cancer in my family; my father and his brother both had prostate. My mother’s sister had breast cancer. My father and uncle opted for immediate surgery to remove the prostate rather than trying chemo or radiation. I believe that my father – who is a big man – did not want to whither away (for lack of a better word) due to the medical treatment that may or may not have worked. To be fair, his doctor was confident that with rounds of chemo and radiation that my father would have been healed of his cancer but daddy just did not want to suffer through all that. I say all that to say, I understand AJ’s decision to go forward with surgery even if just preventive/being proactive. Watching someone die of cancer is no joke and to decide to take control (as much as possible) of one’s own health ahead of time shows strength. I appreciate her talking about it. What she does won’t impact any decisions I make but I can look to her now and appreciate the efforts she is making to educate women and men on the genetic testing, the availability of preventive mastectomies, and how a woman’s self-esteem and self-image is affected.

real life

May 15th, 2013
4:38 am

This is a decision a person needs to make with a doctor. Just because a celebrity did it is no reason to jump on a bandwagon. Ms, Jolie may have made the correct decision for herself but that should not be applied as a blanket approach. And, it should be noted, that this will reduce but not eliminate, her chanced of developing breast cancer. She did not mention having her ovaries removed, which would also seem logical with the family history she describes. (A friend whose mother, 2 aunts and sister died of ovarian cancer opted for a total hysterectomy after genetic testing.) While announcing her decision is good, the media should treat it with a bit more skepticism. I was glad to see yesterday afternoon that many news sites had published articles about the pros and cons of this procedure. This may be the right choice for some, but probably not for all. And it is something to be decided after consulting with medical professionals experienced in both genetics and breast cancer. It is not a decision to be made based on the experience of a celebrity.

Denise

May 15th, 2013
10:10 am

@real life – I completely agree with you. The reason I applaud AJ for publicizing her experience is that people deify celebrities and do not believe they have the same issues that we (”regular”) folks have. I think it is a positive that people who follow the lives of celebrities and idolize them see that what happens to us can happen to them; that what we face, they face as well.

Nadia74

May 19th, 2013
1:45 pm

@GTT, it is preventative. Look it up.

Yes, breast and ovarian cancer runs in my family. Two of my sisters have died from it, at fairly young ages, around 40 years old or younger. Another sister has it now. My grandmother died from ovarian cancer.

I had the gene testing a few years ago. I was negative. However, I had to meet with several doctors during the process, and I knew that if I tested positive, I would have had both breasts removed. Our insurance would have covered it. It is certainly cheaper for them to pay for that than chemo, radiation, and all the surgeries and testing involved if you have cancer.

No, a celebrity’s choice will not affect me. Her speaking about it does no harm, and it helps educate, so I am all for it. Sharon Osborne also had the same thing done. Not so much media coverage for her, though.

Anonymous

May 20th, 2013
8:31 pm

Actually, either preventive and preventative is correct.