Breast cancer and Angelina's choice

'MY MEDICAL CHOICE.' Angelina Jolie's decision to have double mastectomy may be misinterpreted by women as encouragement to undergo the operation even when unnecessary. Photo from the Angelina Jolie Facebook page

'MY MEDICAL CHOICE.' Angelina Jolie's decision to have double mastectomy may be misinterpreted by women as encouragement to undergo the operation even when unnecessary.

Photo from the Angelina Jolie Facebook page

MANILA, Philippines - After Angelina Jolie revealed to the world that she had double mastectomy — a surgical removal of both breasts — many did not know how to react.

Women groups and some members of the medical community lauded her openness on the topic, saying it could encourage more women to take a proactive step towards fighting breast and ovarian cancer. But some also worry that her choice could be spurring the unhealthy “trend” of unnecessary double mastectomy operations among women.

Informed choice

In an article she wrote for The New York Times called “My Medical Choice,” the actress and humanitarian explained that she went for the radical operation after tests revealed she had a rare gene mutation that sharply increased her chances of getting both breast and ovarian cancer. The mutation, called BRCA1, increased breast cancer risk to 65%. Jolie’s doctors estimated that in her case, the mutation brought her risk up to 87%.

What must be first understood about her situation is how special and rare it is. According to NYTimes.com, BRCA mutations — BRCA1 and BRCA2 — cause only 5% to 10% of breast cancer and 10% to 15% ovarian cancer among white women in the US. The mutations have occurred in women from different racial and ethnic groups but there are no records that show how prevalent it is.

“She is a special case and you can completely understand why she did it,” said Dr. Susan Love, a best-selling author and breast surgeon.

Jolie’s double mastectomy was strictly preventive, a decision based on concrete facts that told her it was her best weapon against cancer.  

“My chances of developing breast cancer have dropped from 87% to under 5%,” wrote the 37-year-old actress.

“I can tell my children that they don’t need to fear they will lose me to breast cancer.”

Disturbing trend

So invasive and expensive an operation as a double mastectomy only makes sense for women with a very high risk of breast or ovarian cancer; yet the alarming reality is that there is an increasing demand for mastectomy from women who don’t fall under this category. According to Time.com, the rate of double mastectomies in the US jumped to 150% from 1998 to 2003.

Despite their doctor’s advice against it, some women choose to undergo the complex operation out of sheer paranoia, even if tests show that their cancer risk is not that high. Detection of breast cancer in one breast convince women to have the other, healthy breast removed as well “just to be safe.” Some women have the operation simply because they think their breasts will look better when removed and reconstructed.

Women’s health advocates and doctors hope that Jolie’s choice encourages people to make informed decisions and not rush into medical procedures just because a big Hollywood star had one done.

Get basic facts about breast cancer in this video:

Jolie herself wrote in her article: “For any woman reading this, I hope it helps you to know you have options.

"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.”

Women in families with a history of breast cancer should get genetic tests to find out if they have a genetic predisposition to the disease.

Jolie’s heroic act of openness will only bear fruit if women don’t read just between the lines. - Rappler.com

Pia Ranada

Pia Ranada covers the Office of the President and Bangsamoro regional issues for Rappler. While helping out with desk duties, she also watches the environment sector and the local government of Quezon City. For tips or story suggestions, you can reach her at pia.ranada@rappler.com.

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