Angelina Jolie shocked the world with her announcement that several months ago, she had undergone prophylactic mastectomies after learning that she carried the BRCA1 gene mutation. Jolie’s mother died from ovarian cancer in her mid 50’s which undoubtedly led to Jolie being tested herself. My 3 generations of breast cancer history sent me for genetic testing more than a decade ago as well. After testing positive for BRCA2, I elected to have prophylactic mastectomies and an oophorectomy. I became a “pre-vivor”, a term often referred to those that take surgical measures to prevent cancer from occurring.
Now that this news is being discussed everywhere from tabloids to medical professionals I am wondering about the aftermath of such a public announcement by such a visual personality. Certainly her disclosure has sparked a new interest in breast cancer risk and prevention - and that is a good thing - but I can’t help but wonder if her actions will be interpreted by women who are not in the very specific risk category leading them to feel an over exaggerated sense of personal risk and consequently make decisions that may not be in their own best interest. For those that do carry the mutation, this public decision may also challenge them to take action. In my own family this news has started an email chain discussion about other risks associated with our BRCA2 gene.
Removing healthy breast tissue is both a medical and psychological decision. Surgery does not come without risk. I carefully weighed my own personal risk and made a bold decision to remove my healthy breast tissue. It was the right decision for me. Jolie’s announcement seems to be educating the public about the BRCA1 and BRCA2 genes and the subsequent risks associated with it. A downside to this awareness is that genetic testing can cost more than $4,000 and if not always covered by insurance. The upside is that in 1998 a law was enacted that requires insurance companies to pay for breast reconstruction for mastectomies.
This aggressive approach to breast cancer prevention has been around for awhile but there is no question that a person which such star power as Jolie brings awareness to a new level. Facing your risks and taking control is empowering and it’s my hope that this news does increase awareness but not panic. Personally I thank Jolie for going public with her bold decision. I feel I will be explaining my genes and my treatment decisions less often and may not have to answer why I call myself a “Pre-vivor”.
Susan M. Beausang