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.