Angelina Jolie’s Double Mastectomy: Her Choice, Maybe Not Yours
Actress and social rights activist Angelina Jolie revealed to the media today that she’s recently completed multiple surgeries to remove both breasts, in order to reduce her risk of breast cancer. Is this drastic move something you should consider?
Oscar-winning actress Angelina Jolie, 37, knew that she had a family history of breast cancer; her mother died of the disease at age 56, after having been diagnosed with it 10 years earlier. Jolie, mother of 6 children, decided at some point to be proactive about this family history, and have some genetic testing done.
The test revealed Jolie carries a mutated gene called BRCA1, known to increase a woman’s risk of breast cancer. While oncologists can’t predict with certainty just how great that increase might be (it varies from individual to individual), Jolie’s doctors told her they thought her lifetime risk of breast cancer could be as high as 87% – compared to a 12% risk for the general population.
That information prompted Jolie to have a prophylactic double mastectomy, followed by reconstruction with implants. “Once I knew this was my reality, I decided to be proactive and to minimize the risk as much as I could,” said Jolie. (Casciato, 2013)
Jolie emphasized that she opted to make her story public because she hoped to awaken other women to the fact that their breast cancer risk might be much higher than they think. “…There are many women who do not know that they might be living under the shadow of cancer. It is my hope that they, too, will be able to get gene tested,” she said.
Now, before you call your GP to ask about genetic testing, understand that it’s a very expensive test ($3,000+), and generally not covered by insurance. And there’s no sense being tested if you don’t meet a number of very specific guidelines involving personal and family history. Only about 1 in 300 to 1 in 500 women carry the mutated gene (Casciato, 2013); to find out if you might be one of those women, read our post detailing guidelines for BRCA genetic testing.
If you decide you meet the criteria for testing, and discover you carry a mutated BRCA1 or 2 gene, like Jolie, understand that your risk of breast cancer probably won’t be as high as hers. New research on the genetics of breast cancer, released last month, estimates these faulty genes increase breast cancer risk somewhere between 20% and 85%, so Jolie is on the high end of the scale.
Clearly, reducing her risk of breast cancer from an estimated 87% to about 5% via mastectomy was a reasonable decision for Jolie. But how about you? Your risk might be as low as 20%; just 8 percentage points higher than normal. Before you consider a double mastectomy, understand that it’s a very serious surgery. You could experience lifelong side effects; shoulder issues and lymphedema, a painful, debilitating chronic condition, are both fairly common results of mastectomy.
If doctors think your risk of breast cancer is only minimally greater than normal, do you really want to lose your breasts – and possibly put yourself through years of pain and discomfort?
Bottom line: We salute Jolie’s decision to publicize her surgery in order to raise awareness of breast cancer risk. But we urge you to understand that the odds are extremely small you’ll ever find yourself having to make the decision she did. Chances are minimal you meet the criteria for genetic testing. Even if you do, chances are small that you carry a mutated BRCA gene. And even if you find you’re at increased risk due to mutated BRCA genes, that risk might still be quite small – and should be balanced against the possible long-term effects of double mastectomy.
Casciato, P. (2013, May 14). Angelina jolie has double mastectomy to elude breast cancer. Retrieved from http://www.reuters.com/article/2013/05/14/us-angelinajolie-mastectomy-idUSBRE94D06D20130514
Vaesa, J. (2013, May 14). Angelina jolie has preventative double mastectomy to reduce breast cancer risk. Retrieved from http://www.decodedscience.com/angelina-jolie-has-preventative-double-mastectomy-to-reduce-breast-cancer-risk/30194