The news recently broke that Hollywood superstar Angeline Jolie has had a preventative double mastectomy. Jolie’s mother died of breast cancer, after fighting it for many years, and mother and daughter always had a very good and supportive relationship. Following tests, it was revealed that Angeline Jolie indeed carried the “faulty gene”, which gave her an 85% chance of developing breast cancer at some point in her life.
BRAC1, BRAC2, TP53 & PTEN
There are four genes linked to breast cancer, with are BRAC1, BRAC2, TP53 and PTEN. Everybody actually has these genes, but with most people they function normally. If a mutation or fault is found in one of these genes, the chances of developing cancer are hugely increased. They are linked not just to breast cancer, but also to ovarian cancers. In order to identify whether or not the genes are faulty, a simple blood test is needed.
Around one in ten women will develop breast cancer before they are 80. Not all of these women have the faulty gene. Breast cancer is very common, meaning it can just be a case of bad luck or chance.
It is, however, becoming increasingly common for women who know they have the faulty gene to have a double mastectomy and thereby at least reduce the chances of developing breast cancer. Naturally, a mastectomy surgery does not protect from ovarian cancer.
Should You Have a Double Mastectomy?
If you know you have the faulty gene, you may be considering having a double mastectomy yourself. It is a very personal choice to make, and there are no right and wrong answers. However, if you have the surgery, you will remove the chance of developing breast cancer, which is very important. You do have to be realistic, however. Removing the breasts is major surgery, which you have to be ready for. Besides this, you will have to come to terms with the fact that you will look very differently. You have to take the time to recover, after which you may require further surgery for mastectomy reconstruction. Or, if you opt for specialized clinics you can get the reconstruction right after the removal. However, this complicates the procedure a little.
The majority of women who have a mastectomy recover very well without any complications. Once your wounds have healed somewhat, you may be recommended to wear a mastectomy bra, in which you can insert silicone breasts, so that you continue to have the appearance of breasts. Again, this is a personal decision, because there are numerous women out there who choose not to wear a mastectomy bra and choose instead to remain flat chested. Mastectomy reconstruction is not offered to all women. Someone like Angelina Jolie will be able to afford plastic surgery herself, so the options remain open to her. However, there are many women out there who will simply have to live with their scars and changed appearance, as their insurance will not cover reconstructive surgery.
My question now is for what diagnosed risk of developing breast cancer is it recommended to undergo preventive mastectomy? One would say it that any percentage is high enough. What do you say? This seems to be a case of personal judgement and I wish that no one should ever be confronted with such a choice. Life is not always that simple though…