Angelina Jolie made headlines and shocked many as she announced that she had made the decision to have a preventive double mastectomy. Jolie made the decision after being tested for a mutation of BRCA1, a tumor suppressor gene. The inherited mutation greatly increases a woman’s risk for developing breast and ovarian cancer.

In a New York Times article, Jolie wrote, “Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much I could.”

Jolie’s mother, Marcheline Bertrand, died from ovarian cancer at age 56, after fighting cancer for almost a decade.

By deciding to have the preventive surgery, Jolie said she can tell her children they don’t have to worry about losing her to breast cancer.

“My doctors estimated that I had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer,” Jolie said. After the surgery, her chances of breast cancer dropped to about 5 percent.

Sparing little detail, Jolie explained her procedure in the article, “A procedure known as a ‘nipple delay’, which rules out disease in the breast ducts behind the nipple and draws extra blood flow to the area. This causes some pain and a lot of bruising, but it increases the chance of saving the nipple.”

Jolie said that two weeks later she returned for the major part of the surgery, where the breast tissue was removed and temporary fillers were put in place. “You wake up with drain tubes and expanders in your breasts. It does feel like a scene out of a science-fiction film,” Jolie said.

Nine weeks later Jolie returned one last time for implants, the final reconstruction step.

In contrast, the procedure of a simple mastectomy includes the removal of the entire breast including the nipple and areola. According to Mayo Clinic.com, a mastectomy without reconstruction usually takes one to three hours and a one- to two-day hospital stay.

Some women who choose to have nipple-sparing surgery are concerned that they may have a higher chance of getting breast cancer than non-nipple-sparing procedures. Because there is no breast tissue left behind the nipple, there isn't any increased risk with the procedure. However, even with a mastectomy, women can still get breast cancer, stated Stony Brook School of Medicine.

Through the process, Jolie said she found much support from her husband and encourages other partners to offer the same support. “Know that you are a very important part of the transition.”

Jolie said that she had wanted to be open about her experience with a mastectomy, because she wants other women to benefit from her experience.

“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,” Jolie said.

According to the Center for Disease Control and Prevention, in 2009, 211,731 women were diagnosed with breast cancer and 40,676 died from breast cancer. Breast cancer is the most common form of cancer for women in the United States and is one of the leading causes of cancer among women.

If you have a family history of breast cancer, do not hesitate to research ways to lessen and prevent the onset of cancer. Visit EmpowHER’s breast cancer resource page for more information on the steps you can take and the resources available to you.

Sources:

My Medical Choice. The New York Times. Web. May 14, 2013.
http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html?smid=fb-nytimes&WT.z_sma=OP_MMC_20130514&_r=1&

BRCA1 and BRCA2: Cancer Risk and Genetic Testing. Cancer.gov. Web. May 14, 2013.
http://www.cancer.gov/cancertopics/factsheet/Risk/BRCA

Angelina Jolie's Brave Message. CNN News. Web. May 14, 2013.
http://www.cnn.com/2013/05/14/opinion/caplan-angelina-jolie-mastectomy/index.html

Breast Cancer Statistics. Centers for Disease Control and Prevention. Web. May 14, 2013.
http://www.cdc.gov/cancer/breast/statistics

Mastectomy. Mayoclinic.com. Web. May 14, 2013.
http://www.mayoclinic.com/health/mastectomy/MY00943/METHOD=print&DSECTION=all

FAQs about Nipple-Sparing Mastectomy: What Women Need to Know. Stony Brook School of Medicine. Web. May 14, 2013.
http://medicine.stonybrookmedicine.edu/surgery/blog/faqs-about-nipple-sparing-mastectomy-what-women-need-to-know

Reviewed May 14, 2013
by Michele Blacksberg RN
Edited by Jody Smith