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Angelina Jolie undergoes double mastectomy

Actress Angelina Jolie announced in a New York Times op-ed article on Tuesday that she underwent a preventive double mastectomy after learning she carries a mutation of the BRCA1 gene, which sharply increases her risk of developing breast cancer and ovarian cancer.

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Angelina Jolie announced today she had both of her breasts removed in an effort to stave off a cancer her mother died of at 56.

Statistics show most women, even breast cancer patients, do not carry the BRCA gene. Speaking to your doctor if you have breast or ovarian cancer in your family and seeking a geneticist is the best way for you to find answers.  Knowledge is power in the war against cancer and the BRCA gene which not only raises the risk for breast and ovarian cancers but is also associated with prostate and melanoma skin cancer.

Chicago area doctors weigh in on the best ways for you to protect yourself. And a young mother who had the surgery, says after a double mastectomy, she has never felt more alive.

WGN’s Dina Bair has more.

Dr. Nora Jaskowiak, Breast Cancer Surgeon from the University of Chicago Medicine

Dr. David Song, University of Chicago’s Chief Plastic Surgeon

Actress Angelina Jolie announced in a New York Times op-ed article on Tuesday that she underwent a preventive double mastectomy after learning she carries a mutation of the BRCA1 gene, which sharply increases her risk of developing breast cancer and ovarian cancer.

“My doctors estimated that I had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer, although the risk is different in the case of each woman,” Jolie wrote. “Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much I could. I made a decision to have a preventive double mastectomy.”

Jolie’s mother, actress and producer Marcheline Bertrand, died of ovarian cancer in 2007 at the age of 56. Jolie is 37 years old.

In the Times op-ed, titled “My Medical Choice,” Jolie said she finished three months of medical procedures at the Pink Lotus Breast Center in California on April 27 that included the mastectomies and reconstruction.

A mastectomy is an operation that removes all or part of the breast.

“I wanted to write this to tell other women that the decision to have a mastectomy was not easy. But it is one I am very happy that I made,” Jolie wrote. “My chances of developing breast cancer have dropped from 87 percent to under 5 percent.”

BRCA stands for breast cancer susceptibility genes — a class of genes known as tumor suppressors, according to the National Cancer Institute.

Mutation of the BRCA1 and BRCA2 genes has been linked to hereditary breast and ovarian cancer. A blood test can determine if a woman is “highly susceptible” to the cancers.

Fellow actress Christina Applegate had a similar procedure in 2008. She also had a mutation of the BRCA1 gene.

Oscar-winning film star

Jolie may be best known for title role in the “Laura Croft” series of films, but also won an Academy Award as best supporting actress in “Girl, Interrupted.” She also received a Golden Globe Award and SAG Award for the same role.

Jolie serves as a special envoy for the United Nations High Commissioner for Refugees and has visited refugee camps around the world.

The actress has been in a relationship with actor Brad Pitt since the mid-2000s, and they are engaged. The couple has three biological and three adopted children.

In telling her story, Jolie acknowledged that surgery might not be the right choice for every woman.

“For any woman reading this, I hope it helps you to know you have options,” Jolie wrote. “I want to encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices.”

But for Jolie, the decision ultimately came down to her kids.

“I can tell my children that they don’t need to fear they will lose me to breast cancer,” she said.

It’s a pain Jolie knows all too well from losing her mother to the disease.

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Op-Ed Contributor

My Medical Choice

By ANGELINA JOLIE

My mother fought cancer for almost a decade and died at 56. She held out long enough to meet the first of her grandchildren and to hold them in her arms. But my other children will never have the chance to know her and experience how loving and gracious she was.

We often speak of “Mommy’s mommy,” and I find myself trying to explain the illness that took her away from us. They have asked if the same could happen to me. I have always told them not to worry, but the truth is I carry a “faulty” gene, BRCA1, which sharply increases my risk of developing breast cancer and ovarian cancer.

My doctors estimated that I had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer, although the risk is different in the case of each woman.

Only a fraction of breast cancers result from an inherited gene mutation. Those with a defect in BRCA1 have a 65 percent risk of getting it, on average.

Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much I could. I made a decision to have a preventive double mastectomy. I started with the breasts, as my risk of breast cancer is higher than my risk of ovarian cancer, and the surgery is more complex.

On April 27, I finished the three months of medical procedures that the mastectomies involved. During that time I have been able to keep this private and to carry on with my work.

But I am writing about it now because I hope that other women can benefit from my experience. Cancer is still a word that strikes fear into people’s hearts, producing a deep sense of powerlessness. But today it is possible to find out through a blood test whether you are highly susceptible to breast and ovarian cancer, and then take action.

My own process began on Feb. 2 with a procedure known as a “nipple delay,” which rules out disease in the breast ducts behind the nipple and draws extra blood flow to the area. This causes some pain and a lot of bruising, but it increases the chance of saving the nipple.

Two weeks later I had the major surgery, where the breast tissue is removed and temporary fillers are put in place. The operation can take eight hours. You wake up with drain tubes and expanders in your breasts. It does feel like a scene out of a science-fiction film. But days after surgery you can be back to a normal life.

Nine weeks later, the final surgery is completed with the reconstruction of the breasts with an implant. There have been many advances in this procedure in the last few years, and the results can be beautiful.

I wanted to write this to tell other women that the decision to have a mastectomy was not easy. But it is one I am very happy that I made. My chances of developing breast cancer have dropped from 87 percent to under 5 percent. I can tell my children that they don’t need to fear they will lose me to breast cancer.

It is reassuring that they see nothing that makes them uncomfortable. They can see my small scars and that’s it. Everything else is just Mommy, the same as she always was. And they know that I love them and will do anything to be with them as long as I can. On a personal note, I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity.

I am fortunate to have a partner, Brad Pitt, who is so loving and supportive. So to anyone who has a wife or girlfriend going through this, know that you are a very important part of the transition. Brad was at the Pink Lotus Breast Center, where I was treated, for every minute of the surgeries. We managed to find moments to laugh together. We knew this was the right thing to do for our family and that it would bring us closer. And it has.

For any woman reading this, I hope it helps you to know you have options. I want to encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices.

I acknowledge that there are many wonderful holistic doctors working on alternatives to surgery. My own regimen will be posted in due course on the Web site of the Pink Lotus Breast Center. I hope that this will be helpful to other women.

Breast cancer alone kills some 458,000 people each year, according to the World Health Organization, mainly in low- and middle-income countries. It has got to be a priority to ensure that more women can access gene testing and lifesaving preventive treatment, whatever their means and background, wherever they live. The cost of testing for BRCA1 and BRCA2, at more than $3,000 in the United States, remains an obstacle for many women.

I choose 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.

Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of.

Angelina Jolie is an actress and director.

A version of this op-ed appeared in print on May 14, 2013, on page A25 of the New York edition with the headline: My Medical Choice.
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