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Published on May 14, 2013

Angelina Jolie’s Double Mastectomy and What It Means for Other Women

Hollywood star Angelina Jolie shocked the world this week with an op-ed piece in The New York Times, announcing that she had undergone a preventive double mastectomy and breast reconstruction surgery over the last three months—without the public knowing anything about it.

Double mastectomy, which is the surgical removal of both breasts, is often done as a way to treat breast cancer. However, some women who are at a high risk of developing breast cancer can opt to have the surgery performed in order to reduce their chances of getting the disease. According to the National Cancer Institute, the surgery can lower one’s risk of breast cancer by 90 percent.

Thomas Matulewski, M.D., medical director of the Center for Breast Health at Delaware County Memorial Hospital, says he supported Jolie’s decision to have the surgery. “It was a wise choice for her own health and for her family,” he says. “It was rather courageous to encourage other women to consider this as an option because of the high risk of breast cancer associated with hereditary cancers.”

In her op-ed, Jolie described her experience and openly discussed her decision to have both breasts removed after learning she tested positive for a mutation of the BRCA1 gene, which raised her risk of breast cancer to 85 percent. Mutations of the BRCA1 and BRCA2 genes have been found to increase one’s chances of developing both breast cancer and ovarian cancer, and they can be identified from a simple blood test.

However, Matulewski went on to say that even though many women take advantage of this procedure after discovering they have a mutated gene, hereditary cancer is rather uncommon. Less than 10 percent of all patients with breast cancer developed it as a result of possessing mutated BRCA1 and BRCA2 genes.

So how do you know if you should be tested for the BRCA genes?

Well, there are certain criteria you should meet before being tested. But the most important factors are personal and/or family history of ovarian or breast cancer. Dr. Matulewski said that men should be tested as well, because they can carry the gene and pass it along to their children if someone in their family had breast and/or ovarian cancer.

If the test comes back positive for either type of cancer, you should discuss with your doctor if surgery is the right step for you. There’s a lot to consider when making this decision, such as the emotional and physical effects that can result after having a preventive mastectomy or oophorectomy (which is the removal of the ovary). It’s important to also consider reconstructive options that are currently available if you decide to have surgery.

In the case that the test comes back negative, Matulewski cautions that this doesn’t mean you aren’t at risk for these cancers.

There are new genes being discovered constantly that are associated with the development of breast cancer,” Matulewski says. Given that, he recommends that men and women undergo genetic counseling for other abnormalities, in case a person with a family history of either disease tests negative.

For the majority of women who don’t have a family history of breast or ovarian cancer, they should be sure to have frequent screenings to catch any disease early on.

Learn more about cancer care at http://ckcancer.crozerkeystone.org. Thomas Matulewski, M.D. can be reached at the Center for Breast Health at Delaware County Memorial Hospital at (610) 394-1840.

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