Like Jolie, More Women Choosing Mastectomy

News yesterday about Angelina Jolie’s double mastectomy sparked numerous discussions across TV talk shows, entertainment blogs and mainstream news outlets.

The actress revealed in a New York Times editorial piece that she had undergone a double mastectomy in February after finding out that she carries the gene identified in some patients who later develop breast and ovarian cancer.

Jolie’s choice brings to light a decision that many women, as well as men, face in their own lives.

Robert DerHagopian, M.D., medical director of Baptist Health Breast Center, says that many people with a family history of breast cancer opt to undergo genetic testing to determine their risk for developing the disease later on in life. Knowing their risk, Dr. DerHagopian says, helps these people decide what course of action to take.

More and more women with breast cancer or who carry the BRCA1 or BRCA2 genes – those genes common in breast and ovarian cancer patients – are choosing to have a preventive mastectomy like Jolie, Dr. DerHagopian says.  He says that over the last decade, the more conservative surgical approach – the lumpectomy with subsequent radiation – has fallen out of favor for many of his patients.

He cites the following reasons for the upward trend in preventive mastectomies:

• Better breast reconstruction techniques exist now, making the cosmetic appearance of the breasts much more natural than in years past.
• People who have breast cancer don’t want to worry about a recurrence, as they would with a lumpectomy and radiation.
• Many breast cancer patients worry about radiation exposure, which he says is minimal.

Research indicates that women who carry the BRCA1 and BRCA2 genes have a 70-80 percent risk of developing breast cancer and a 25-50 percent risk of developing ovarian cancer over their lifetime.  Their breast cancer risk drops to below 1 percent when they have their breasts removed. Men who carry one of the genes have a higher risk of developing breast and prostate cancer later in life.

“Since we have advanced imaging technology to detect early breast cancer and ovarian cancer is harder to detect, I strongly recommend removing a woman’s ovaries after childbearing years if she carries the gene, even more so than the removal of breast tissue,” he said.  “For men with the gene, we recommend screening for both breast and prostate cancer.”

Jolie decided to share her story with the world because it raises awareness of choices available in breast-cancer prevention and how genetic testing plays a role in those choices.

What do you think?