Conditions

Angelina Jolie Undergoes Double Mastectomy To Avoid Breast Cancer; Plastic Surgery to Reconstruct Breasts

Angelina Jolie and Brad Pitt at the 69th annual Golden Globe Awards
Angelina Jolie, shown here with husband Brad Pitt at the Golden Globe Awards in January of 2012, recently completed a double mastectomy and reconstructive plastic breast surgery, as a measure to lessen her risk for breast cancer. Reuters

In a very personal Op-Ed piece published today in the New York Times, Oscar-winning actress and director Angelina Jolie revealed that this past April she completed a double mastectomy as a preventative measure to avoid breast cancer. The decision came after her discovery that she carried the BRCA1 gene, which is known to increase a woman's risk for developing both breast cancer and ovarian cancer. Jolie did not state whether or not she will also have an oophorectomy to remove her ovaries. 

"My doctors estimated that I had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer," Jolie wrote. "Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much as I could."

Besides the medical diagnosis, personal history likely played a role in her decision; Jolie's mother, actress Marcheline Bertrand, died of ovarian cancer at age 56, and she expressed her sadness in the fact that her six children never got to meet her mother. 

"I find myself trying to explain the illness that took her away from us. They have asked if the same could happen to me," Jolie wrote. So Jolie decided to take the most proactive approach available to her: she had her breasts surgically removed. 

Jolie began her surgical procedures on February 2 with a "nipple delay," a process that studies have shown to help save the nipple in cases where a mastectomy is necessary. It's a relatively new procedure; in the past, surgeons rarely were able to preserve the nipple in a mastectomy, because of the fact there are ducts within the nipple that can  cause breast cancer. However, new techniques allow doctors to more effectively rule out cancer in the nipple ducts, and save the nipples as a result.  

In mid-February, Jolie underwent the actual mastectomy. Depending on an individual's situations, there are a few different approaches a surgeon could take. Jolie had what is called a "nipple-sparing (subcutaneous) mastectomy," where the surgeon removes only the breast tissue, attempting to spare the skin, nipple, areola and chest wall muscles. Afterward, temporary tissue expanders are placed behind the chest wall muscles in order to form a new breast mound; drain tubes are also placed in the breasts to help rid the area of any fluids that have accumulated because of the surgery.

"It does feel like a scene out of a science-fiction film," wrote Jolie of waking up the day after surgery. "But days after surgery you can be back to a normal life."

After a few months, Jolie finished the process on April 27th by having plastic surgery to reconstruct both of her breasts. Jolie was extremely positive about the procedure in her Op-Ed, stating "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." She also called the end-results of her procedures "beautiful." Jolie expressed gratitude towards her partner, actor Brad Pitt, for his support and thanked the supportive partners of all women facing breast cancer.

In the article, Jolie goes on to express the importance of screening, lamenting the fact that BRCA1 and BRCA2 testing, at over $3000, is cost-prohibitive for the majority of women both in the United States and globally. 

"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," Jolie wrote. She hopes, however, that her story can serve as a source of inspiration and knowledge to other women — while it is likely that she could have kept the whole breast removal under wraps, she has chosen to make this very private matter a public one so that other women will feel encouraged to seek out additional information on their cancer risk and options.

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

 

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