A mother, award-winning actress, renowned philanthropist and partner of Brad Pitt, Angelina Jolie appears to have it all. She is a vibrant woman who recently made the courageous decision to have a double mastectomy. Many women, especially those at heightened risk for breast cancer, may now be wondering if she made the best decision, and whether it is a decision they should also consider making.
Jolie underwent a preventive double mastectomy because she learned that she carries a rare mutation of the BRCA1 gene, which significantly boosts her risk of developing both breast and ovarian cancer. Her mother also died of ovarian cancer at 56.
“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,” Jolie wrote in an op-ed in the New York Times. “Once I knew that was my reality, I decided to be proactive and to minimize the risk as much as I could.”
As noted by the National Cancer Institute, BRCA stands for breast cancer susceptibility genes, a class of genes referred to as tumor suppressors. Mutations of the BRCA1 and BRCA2 genes have been linked to hereditary breast and ovarian cancer. A blood test can determine if a woman is at very high risk of these cancers.
While Jolie’s choice was certainly a difficult one, it gives her greater peace of mind by reducing her risk of developing breast cancer from 87 percent to under 5 percent. “For any woman reading this, I hope it helps you to know you have options,” she wrote. “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 every woman who has a higher risk of breast or ovarian cancer should have a preventive procedure like Jolie’s. In fact, the U.S. Preventive Services Task Force recommends that only women with a strong family history of cancer be evaluated for genetic testing for BRCA mutations. This group represents only about 2 percent of adult women in America.
For women who have breast cancer (without genetic mutations like Jolie’s), there are newer procedures becoming available, even right here in southwest Michigan. Today, breakthrough approaches to surgery are changing the way having a lumpectomy (a breast lump removed) or a mastectomy (removal of the whole breast) is performed, offering women faster treatment, smaller scars, fewer long-term side effects, and enhanced cosmetic results. In short, breast cancer surgery is trending toward the minimally invasive, providing women access to better treatment options than ever before.
Daniel Barnas, MD, FACS, is Kalamazoo’s first fellowship trained breast surgeon, and part of Borgess Surgical Specialties. To speak with someone at Borgess Surgical Specialties, please call (269) 226.5456.