Double Mastectomy: Angelina Jolie’s choice is not advice

Double Mastectomy: Angelina Jolie’s choice is not advice

I heard on BBC’s World News today that Angela Jolie is advising women to have preventive double mastectomies. When I raced home to read her New York Times piece, “My Medical Choice,” I was relieved to see that, at least in this piece, she is doing nothing of the sort. I hope she never gives this advice. Here’s why.

You are not Angelina Jolie: The operative words in the title of Jolie’s opinion piece are “my” and “choice.” It’s important to read the details of her story very carefully. She carries a mutation of the BRCA1 gene. The gene itself, along with BRCA2, are tumor suppressors. Faulty versions greatly increase your risk of breast cancer.

As Jolie notes in her piece, the decision to have a double mastectomy was deeply rooted in her specific health history. It is not always the right decision for everyone, and it is sometimes absolutely the right decision.

Angeline Jolie can still get breast cancer: Though Jolie has significantly decreased her risk of getting breast cancer, it’s important to remember that a woman with a double mastectomy can still get breast cancer. No matter how radical, breast cells are still left behind after a mastectomy. And though the mutated genes increase risk of getting cancer, they aren’t the only risk. Drinking alcohol and smoking both significantly increase your risk and Angelina Jolie’s risk of getting breast cancer.

Mastectomy carries its own risks. Risks that accompany mastectomy are many and significant. They share the risks that all surgeries share: bleeding, infection, longterm pain.

In addition, lymphedema is a risk, and it’s a big one. Google images of lymphedema to get an idea, but I’ll describe it as permanent swelling located where lymph nodes have been removed. It’s an ongoing side-effect that most breast cancer survivors struggle with.

It’s painful, and it’s limiting. Women are generally advised to limit their air travel and to wear a compression sleeve when they do fly. I know plenty of women choose to never fly again rather than risk lymphedema.

lotusAngelina Jolie has more money than you do. As she mentions in her Times piece, testing for the gene mutation costs $3000. Not all insurance companies cover preventive mastectomy. If they do, they probably won’t give you the choice of going to the Pink Lotus Breast Center, where Jolie’s procedures took place. In fact, my insurance company wouldn't even cover my choice of a local specialist for a second opinion.

I’m grateful that celebrities such as Angelina Jolie go public with hard decisions. She has power and influence in our celebrity- and wealth-driven culture and she is using that power to shape public opinion about health matters. I have no doubt that she will empower uninsured women to make the same choices that she has made. So, good for her. My advice to you is to do the same hard work that she did before making a huge decision like this. Read, research, talk, investigate. You’d be amazed how many people don’t.

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