Angelina Jolie Double Mastectomy
ANGELINA JOLIE reveals she had a preventative double mastectomy after learning she carried a breast cancer gene. The Oscar-winning beauty and Brad Pitt partner to Brad Pitt revealed the new in an op-ed piece she wrote for The New York Times entitled, "My Medical Choice."In the heart wrenching piece, Jolie, 37, writes she completed three months of surgical procedures to remove both breasts that between early February and late April. She wrote that her thoughts were of her six children after watching her own mother, Marcheline Bertrand die from cancer.
What is double mastectomy?
Double mastectomy, meaning she chose to have both her breasts removed even though she had not been diagnosed with cancer.
Q: Why did she have the mastectomies?
A: Jolie says that she has a "faulty" version of the BRCA1 gene that means she had an 87 per cent chance of getting breast cancer. By having both breasts removed preventatively, she said her breast cancer risk drops to below 5 per cent.
Q: What did the procedure involve?
A: In double mastectomies, surgeons typically remove as much breast tissue as possible. In Jolie's case, because she was having a reconstruction done shortly afterward, the doctors preserved the skin covering her breasts, inserting "fillers" where the breast tissue would have been, to keep the skin elastic. According to Jolie, she had implants put in nine weeks later.
Q: How many women have this faulty gene?
A: Only a small percentage of women have this same faulty gene, or a similar mutated version of a related gene, BRCA2. These mutations are most commonly found in women of Eastern European Jewish descent; one study found 2.3 per cent of women in that group had the mutations -- about five times higher than in the general population. Other ethnic groups, including the Norwegian, Dutch and Icelandic people, also have slightly higher rates of these mutations.
Q: How do these genes increase a woman's risk of breast cancer?
A: The average woman has a 12 per cent risk of developing breast cancer sometime during her life. In comparison, women who have inherited a faulty version of a breast cancer gene are about five times more likely to get breast cancer. In the U.S., about 5 to 10 per cent of breast cancers are thought to be linked to harmful versions of the BRCA1 and BRCA2 genes.
Q: How can women find out if they have these gene mutations?
A: A genetic test using a blood test can usually detect these genes. In the U.S., there are no standard guidelines recommending women for BRCA1 or BRCA2 genetic testing. The tests usually cost at least several hundred dollars. Women may be at higher risk for having a harmful mutation if they have close family members diagnosed with breast or ovarian cancer at an early age. Jolie says that her mother fought cancer for nearly a decade before dying at age 56.
Actress Angelina Jolie, who carries a mutation in her BRCA1 gene, announced that she has had a double mastectomy. Women who carry a BRCA1 or BRCA2 mutation have a significantly higher risk of developing breast and ovarian cancers. According to Angelina Jolie, her lifetime risk of developing breast cancer before having her breasts surgically removed was 87%. Having the BRCA1 mutation also means a 50% lifetime risk of ovarian cancer. According to scientists at the Johns Hopkins Kimmel Cancer Center, carrying the BRCA1 mutation may also be linked to other cancers. Jolie's mother, Marcheline Bertrand, died of ovarian cancer* on January 27th, 2007. Jolie elected to have a double mastectomy to minimize her risk of breast cancer. She has also intimated that she may consider having her ovaries removed (Oophorectomy).
Jolie's mother died of ovarian and not breast cancer. Many newspapers and TV channels have mistakenly reported she died of breast cancer. In an article in the Opinions section of the New York Times, titled "My Medical Choice", Jolie writes about her mother who died of cancer at the age of 56, and held out long enough to hold one of her grandchildren in her arms. Her other grandchildren will never have the opportunity to know her, she added. Jolie's children refer to her mother as "Mommy's mommy". After explaining the illness that took her away, her children asked whether the same could happen to her. She would answer by telling them not to worry, but knew that she carries the mutated (faulty) BRCA1 gene. Jolie emphasized that the risk of breast and/or ovarian cancer in women with the BRCA1 mutation varies from case to case - her doctors estimated her lifetime risks are 87% and 50% respectively. A small fraction of breast cancers are caused by an inherited gene mutation. The average risk of developing cancer for women with the BRCA1 defect is approximately 65%, Jolie wrote. As soon as she realized what her odds were (of developing cancer), Jolie decided to be proactive and reduce her risk to a minimum.
Jolie wrote,"I made a decision to have a preventive double mastectomy. I started with the breasts, as my risk of breast cancer is higher than my risk of ovarian cancer, and the surgery is more complex. On April 27, I finished the three months of medical procedures that the mastectomies involved. During that time I have been able to keep this private and to carry on with my work. "
I hope other women can benefit from my experience
Jolie explains that she has made her decision public in the hope that other women may benefit from her experience. The word "Cancer" still triggers fear and a deep sense of helplessness. However, today people can find out whether they carry the BRCA1 or BRCA2 gene defect through a blood test - and then take action. On a personal note, I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity."Nipple-delay procedure - Jolie's process started on February 2nd, 2013 with a "nipple delay", which rules out malignancy in the breast ducts that lie behind the nipple and draws more blood flow to the area. Although painful, it increases the chances of saving the nipple. Major surgery two weeks later - two weeks later breast tissue was surgically removed and replaced with temporary fillers during an eight-hour operation. Jolie described waking up with drain tubes and expanders in her breasts. Although she initially felt as if she were in "a scene out of a science-fiction film", within days she was able to get back to her normal routine.
Breast reconstruction - nine weeks after breast tissue removal, Jolie underwent the final surgery to rebuild each breast with an implant. Breast reconstruction has made huge advances over the last twenty years. Not an easy decision to have a mastectomy Jolie tells other women that her decision to have a double-mastectomy was not an easy one to take. However, it is one she is very happy with today. Her risk of developing breast cancer is now 5%, a considerable drop from 87%. She says she can now reassure her children truthfully that they need not fear losing her to breast cancer.
Jolie wrote (regarding her children),"It is reassuring that they see nothing that makes them uncomfortable. They can see my small scars and that's it. Everything else is just Mommy, the same as she always was. And they know that I love them and will do anything to be with them as long as I can. On a personal note, I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity. I am fortunate to have a partner, Brad Pitt, who is so loving and supportive. So to anyone who has a wife or girlfriend going through this, know that you are a very important part of the transition. Brad was at the Pink Lotus Breast Center, where I was treated, for every minute of the surgeries. We managed to find moments to laugh together. We knew this was the right thing to do for our family and that it would bring us closer. And it has."
Women need to know that they have many options. Jolie says she wants to encourage every adult female, especially those with a family history of ovarian and/or breast cancer, to talk to their health care professionals who can help them through this aspect of their lives, so that they can make their own informed choices. Jolie added "I acknowledge that there are many wonderful holistic doctors working on alternatives to surgery. My own regimen will be posted in due course on the Web site of the Pink Lotus Breast Center. I hope that this will be helpful to other women." According to WHO (World Health Organization), breast cancer kills approximately 458,000 people annually worldwide - the majority of deaths occur in low- and middle-income nations. Health care authorities, agencies and NGOs need to make sure that women have access to gene testing and lifesaving preventive treatments, regardless of their incomes and backgrounds. In the USA, testing for BRCA1 and BRCA2 costs $3000 - too expensive for the majority of women worldwide. Jolie added, “I choose not to keep my story private because 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, and that if they have a high risk they, too, will know that they have strong options. Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of."
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