On May 14, 2013, The New York Times published an article in The Opinion Pages section of the newspaper written by actress and director Angelina Jolie titled “My Medical Choice,” wherein she disclosed her decision to undergo a preventive double mastectomy. She underwent a double mastectomy after discovering that she carries a mutated “breast cancer 1” (BRCA1) gene, which gave her an 87 percent risk of developing breast cancer and 50 percent risk of developing ovarian cancer. Jolie’s preventive double mastectomy surgery reduced her risk of developing breast cancer to less than 5 percent.
Jolie’s surgeon, Dr. Kristi Funk, detailed the entire process in her blog on the Pink Lotus Breast Center webpage. After much surveillance and deliberation, the first procedure Jolie underwent was called a “nipple delay.” This procedure is performed to ensure there is no disease in the breast ducts behind the nipples in order to allow the nipples to remain and be used for the breast reconstruction surgery. Two weeks after that, the double mastectomy was performed to remove the breast tissue and replace it with temporary expanders until reconstruction was completed with implants. Jolie and her surgeon chose the newly FDA-approved anatomic teardrop-shaped implants with allograft (synthetic sheets of material) for a more natural appearance.
Angelina Jolie encourages other women to be aware of their options when it comes to preventing and treating breast cancer. She advocates accessibility to breast cancer gene testing (which typically costs more than $3,000 in the U.S.) for all women with a family history of breast or ovarian cancer in order to find out if they are at an increased risk for breast cancer. Jolie also believes that women with a genetic risk for breast cancer should have the option to undergo preventative surgery. Her choice may empower other women at high risk to consider a preventive double mastectomy as a way to protect themselves against breast cancer.
Although Jolie’s announcement of her procedure has made many women more aware of their options, certain doctors worry that some may misinterpret her decision and undergo preventive mastectomies unnecessarily. It is important to realize that Jolie’s condition was extremely rare, as abnormal genes are the cause of only 5 to 10 percent of all breast cancer cases. Each woman’s individual circumstances are different, and surgery is not always the best option for everyone. It is important to discuss risk factors and options regarding breast cancer with a qualified physician to evaluate individual circumstances and determine the best plan of action for battling breast cancer.
How to Reduce the Risk of Breast Cancer
Mammograms and other preventative measures reduce your risk for breast cancer.
Unfortunately, there is no guaranteed way to prevent breast cancer. However, the best way to battle the odds is to take measures to reduce the risk and aid in the early detection of breast cancer.
Maintain a healthy diet
Consuming fruits, vegetables, and whole grains may help reduce the risk of breast cancer, while dietary fats and processed grains may increase the risk. Although dietary measures have a noticeable impact on cancer prevention, unfortunately, they are not proven effective in battling against other breast cancer risk factors.
Limit alcohol consumption
It is extremely important to restrict excessive alcohol consumption; consuming more than two drinks per day increases the risk of breast cancer by 41 percent.
Increase exercise
Exercise reduces the amount of estrogen, testosterone, insulin, and other growth factors in the body that may cause or increase the development of breast cancer. Evidence from over 50 studies shows that the risk of developing breast cancer is 20 to 30 percent lower for women who exercise 4 to 7 hours per week at moderate to vigorous intensities compared to less active individuals.
Consider medications
The risk of breast cancer has been shown to be reduced by certain medications that counter the effects of estrogen. Women at a high risk for breast cancer should discuss with their doctor whether or not these drugs would be beneficial to them.
Practice methods for early detection
Regular breast exams are very important for the early detection of breast cancer. The sooner the diagnosis, the sooner treatment can begin and the more likely breast cancer can be defeated.
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Examine your breasts once a month for irregular lumps or any other changes. To learn more about this early detection technique, watch how to do a breast self-exam (BSE).
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Have a mammogram once a year, starting around age 40 (or earlier if your family has a history of breast cancer).
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Get a thorough physical exam twice a year.
Know your risk
Genetic testing can determine if a woman has an abnormal gene that can put her at a higher risk for developing breast cancer. Women with the following conditions are more likely to have a mutated breast cancer gene:
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Blood relatives (grandmothers, mother, sisters, aunts) on either your mother’s or father’s side of the family who were diagnosed with breast cancer before age 50
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A family history of breast cancer and ovarian cancer, particularly in a single individual
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A family history of other gland-related cancers, such as pancreatic, colon, and thyroid cancers
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Women in your family with cancer in both breasts
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A man in your family with breast cancer
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You are of Ashkenazi Jewish (Eastern European) heritage
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You are an African American diagnosed with breast cancer at age 35 or younger
If you have undergone a mastectomy procedure and are interested in breast reconstruction or any other procedures in Alabama, please contact Plastic Surgery Specialists by calling (205) 298-8660. Our board-certified plastic surgeons, Dr. Robert I. Oliver, and Dr. Jason M. Jack, look forward to helping you achieve the appearance you desire.