If you found out you were susceptible to breast cancer, but hadn’t actually developed it, what would you do? In an op-ed published in the New York Times this morning, Angelina Jolie chronicles her own journey and the surprising choices she’s recently made as she’s dealt with this very question. It brings up a lot of interesting and important issues,
Angelina’s mother lost her battle against cancer at the relatively young age of 56. She speaks often to her children of “Mommy’s mommy,” trying to explain why she isn’t here anymore; naturally, they’ve asked her if the same could happen to her. She tells them not to worry, but after she had a genetic test performed, she discovered that she carries the BRCA1 genetic flaw, which greatly increases her risk of developing both breast and ovarian cancer. What to do?
Her doctors estimated that she had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer. On average, women with the same defect in BRCA1 have a 65 percent change of developing breast cancer, so Angelina’s estimate was on the higher end. As such, she decided to “be proactive” and “minimize the risk” as much as possible—by having a preventative double mastectomy.
She started what would become three months of medical procedures on February 2 and finished the last of it on April 27. Brad Pitt was with her for every second of her treatment, and she writes, “We knew this was the right thing to do for our family and that it would bring us closer. And it has.” Angelina’s chances of developing breast cancer have dropped from 87 percent to under 5 percent; she remarks, “I can tell my children that they don’t need to fear they will lose me to breast cancer.”
Angelina notes that she started with the breasts because her risk of breast cancer was higher than her risk ovarian cancer; additionally, she comments that the surgery is more complex. Is she planning on undergoing a similar procedure for her ovaries? Although I think she implies that she might—she got the more complex surgery over with first, leaving the less difficult one for the future—she doesn’t expressly say it, so maybe she won’t. We’ll have to wait and see.
It might be both a blessing and a curse that we’re able to test for things like this. On the one hand, as Angelina is advocating, it enables us to take preventative action; but on the other, it also leaves us with the specter of whether or not we’ll develop breast cancer, or ovarian cancer, or any of the other things we might test positive for, hanging over our heads—and it’s possible that unlike Angelina, we may not be able to undergo a full double mastectomy as a preventative measure. We might not have the funds available to do so, or the insurance coverage, or even the desire to do it in the first place. So, if you’re among the numbers who wouldn’t, for whatever reason, be able to undergo a double mastectomy, what do you do if you find out that you’ve got the BRCA1 or BRCA2 gene? I honestly don’t know what I would do, and I’m sure I’m not the only one who hopes that I never have to find out—but the reality of it is that one day I might. There IS a history of breast cancer in the women in my family, so the risk is there.
Then again, Angelina’s point is really about raising awareness and letting women know that whether or not they chose as she did to have a double mastectomy, they have options. She encourages women—especially those with family history of breast or ovarian cancer—to get informed so they can make the best choices for them. She might even be trying to start waves geared towards making the test itself, which can cost over $3,000, and preventative treatment more affordable: “Breast cancer alone kills some 458,000 people each year, according to the World Health Organization, mainly in low- and middle-income countries,” she writes. “It has got to be a priority to ensure that more women can access gene testing and lifesaving preventative treatment, whatever their means and background, wherever they live.”
Angelina ends on a positive note about taking on the challenges presented to us in life; “the ones that should not scare us,” she says, “are the ones we can take on and take control of.” And I mostly agree with this sentiment, although I wonder again what the “options” she somewhat vaguely brings up are for those of us who might not be able to take the same course of action she did. It’s one thing to have the knowledge—but what do you do with it once you’ve got it?
Tell us: Have you or would you get tested for the BRCA1 and BRCA2 gene? What did or would you do with the knowledge you gained from it?
Lucia Peters is BettyConfidential’s senior editor.