I was delighted.
Angelina is brave and bold, and knows we need to change the conversation about taboo topics such as breast cancer and prevention. I hope that her grace and honesty throughout the ordeal will encourage other women to get the tests and seek the solutions they need to prevent the tragedy of breast cancer. Christina Applegate underwent the surgery years ago, and she’s still hot and rockin’.
When women take control of their health, good things happen.
When Your Genes Don’t Fit
As Angelina says, “I have the faulty gene.” The overall rate of an inherited mutation in BRCA1 and BRCA2 are rare, and range from 1 in 300 to 1 in 800. Certain ethnic groups have been shown to have a higher carrier frequency (for example, 1 in 40 individuals of Ashkenazi Jewish descent). Only 5 to 10% of breast cancer is genetic, but of the inherited type of cancer, two thirds occur in people with BRCA1 or 2 mutations.
Double Whammy: If I’ve had a mastectomy, should I also get a hysterectomy?
Both men and women who have harmful BRCA1 or BRCA2 mutations have an increased risk of cancers, and when a woman inherits a BRCA1 or BRCA2 mutation, her risk of developing breast or ovarian cancer is increased. Hysterectomy is often presented as an option along with prophylactic mastectomy. It reduces risk but not curative – because you can’t remove 100% of ovarian or breast tissue, so you still need monitoring. Many women find the surgery provides peace of mind.
There’s a good chance Angelina will choose to have prophylactic surgery one day, depending on her comfort with risk. Many younger women Angelina’s age will get intensively monitored with ultrasounds of the ovaries and breasts, and breast MRI, and do that until they are 100% certain they are done with having babies.
The Surgery Standoff
Many women don’t want to remove their option to have another baby, and don’t want to deal with the instant menopause that the oophorectomy (removal of ovaries) creates. Other women don’t want a big surgery, or don’t want to give up the organs that most define them as a woman. It’s a very personal decision, to be made collaboratively with your clinician and genetics counselors.
Also, a mastectomy is not right for everyone. In a new study, researchers at MD Anderson Cancer Center in Houston provide the first evidence that preventive mastectomy prolongs life, but only for a subset of breast-cancer patients. For the majority of women diagnosed with the disease, the drastic and deforming surgery is more than they need, the study concludes.
Bold & Beautiful
Angelina Jolie is raising awareness, not just of a pervasive health issue, but of the ever-evolving solutions available. This is next gen medicine – soon we will all know our genetic risks and face similar decisions about what risks we can live with and how to move forward to create the best health possible. As always, I encourage women to test early and often, and to research all their options when it comes to preventative measures. New science and less invasive techniques are emerging all the time, so do a little research on your own and don’t be afraid to ask hard questions of your doctor; this is YOUR life. Be a trailblazer. Own it.