Angelina Jolie Writes about Prophylactic Mastectomy

Angelina_Jolie_Cannes_2011Actress Angelina Jolie has authored an opinion piece in the New York Times about her choice to have a prophylactic mastectomy to reduce her risk of breast cancer. Ms. Jolie says her family and genetic history gave her an 87% risk of having breast cancer, and that the surgery reduced that risk to under 5%. She says she chose “not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer. It is my hope that they, too, will be able to get gene tested, and that if they have a high risk they, too, will know that they have strong options.”

We asked Otis W. Brawley, M.D., chief medical officer, for his reaction to the piece.

“While only a small number of breast cancers are linked to known genetic risk factors, women facing such a high risk need to know that, and need to be able to discuss their options with genetic specialists and knowledgeable health professionals so they can have all the information and expertise at their fingertips to do what’s right for them.

“This does not mean every woman needs a blood test to determine their genetic risk for breast and/or ovarian cancer. What it does mean is women should know their cancer family history and discuss it with their regular provider. If appropriate, they should be referred to and have the opportunity to discuss their risk and their options with a genetic specialist.

Otis Brawley

Otis Brawley, MD, Chief Medical Officer, American Cancer Society

“Insurance plans created before the passage of the Affordable Care Act are not required to cover the costs of genetic counseling, testing, and any surgery to reduce the risk of breast cancer. Under the Affordable Care Act, new plans are required to cover the costs of counseling and testing for breast cancer risk. There is no such mandate for the coverage of surgery.

“A prophylactic (preventive) mastectomy, removing both breasts before cancer is diagnosed, can greatly reduce the risk of breast cancer, by as much as 97%. It does not completely prevent breast cancer because even a very careful surgeon will leave behind a small amount of breast tissue, which can go on to become cancerous.

“Women with BRCA mutations associated with a high risk of breast cancer, confirmed by testing, and with a strong family history of breast cancer, a previous breast cancer, and who show signs of certain pre-cancerous conditions are among those who could benefit from the surgery. A woman with a mutation of known significance must consider her quantifiable risk in making the very personal decision to have her breasts and ovaries removed or pursuing other options, such as more extensive screening for breast and ovarian cancer. Experts recommend women proceed cautiously, and receive a second opinion before deciding to have this surgery. The American Cancer Society Board of Directors has stated that ‘only very strong clinical and/or pathologic indications warrant doing this type of preventive operation.’ Nonetheless, after careful consideration, this might be the right choice for some women.”

For more information, please see: “Can Breast Cancer Be Prevented?” on cancer.org.

About David Sampson

I am the director of medical and scientific communications for the American Cancer Society national home office.
This entry was posted in Breast, Prevention. Bookmark the permalink.

6 Responses to Angelina Jolie Writes about Prophylactic Mastectomy

  1. katherinembc says:

    It’s instructive to compare Jolie’s statement with some that Christina Applegate made when Applegate made a similar disclosure. Jolie seems pretty well informed: http://www.cancer.org/aboutus/drlensblog/post/2008/08/30/did-christina-applegate-send-the-right-message.aspx

  2. Could you please link the full ACS Board of Directors statement quoted? I’d like to know more about the evidence and risks; the discussion at http://www.cancer.org/cancer/breastcancer/detailedguide/breast-cancer-detection is good but not detailed enough. I can’t find it from online searches, just repeats of the same quote. Thanks.

  3. Pingback: Angelina Jolie double mastectomy: Brad Pitt reacts – All Headway Themes

  4. Pingback: Angelina Jolie, Genetic Testing and the ACA

  5. Jan Greeff says:

    This is rather misleading, considering the fact that cancer is a lifestyle-related disease. I would prefer to see ms. Jolie investigating and publicising the benefits, including immunity against cancer, of a healthy lifestyle. Immunity to cancer is linked to neutral or slightly alkaline body fluids, which is within reach of all who take a healthy lifestyle seriously. This approach would have a far greater positive impact on her followers than the wave of masectomies that her decision will in all likelihood be initiating.

  6. Pingback: Is Angelina Jolie’s Medical Choice Now Covered Under Affordable Act?

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