Prophylactic Double Mastectomy and Angelina Jolie

Angelina Jolie is not the first, nor will she be the last woman to have a double mastectomy to reduce breast cancer risk.  Giuliana Rancic did the same after her breast cancer diagnosis a couple of years ago.  She actually did have cancer at that point, but chose to remove all of both breasts to reduce further risk.

I have known that I was extremely high risk for breast cancer since I was in high school.  My grandma died of breast and lung cancer and my mom was diagnosed with breast cancer when I was 13.  She was 44.  My mom survived.  So did my aunt about 10 years later.

Because of the high incidence of breast cancer in our family, my mom had the complete genetic workup which they do for the first person who is tested. She was found to have a BRCA2 mutation (there are many different mutations within the gene).  This is associated with a higher risk for breast and ovarian cancer, just like the BRCA1 mutation that Angelina Jolie has.

So my aunt, my sister, and I all got tested for the specific mutation that my mom has.

My aunt did it first...before my mom even told us about her test and she found that she is also positive.

My sister and I got tested together at a joint doctor's appointment (it's just a blood test).  Waiting for the results was the hard part.  I knew that I would feel terrible if my sister was positive and I was not.  It turns out that we're both positive and in this together, which is comforting - although I still wish she did not have the mutation.

As bad as it may sound, I have always thought that I would get breast cancer, so the result did not shake my world.  It was actually a good thing, because it's a specific tool to get doctors to take my cancer risk seriously.

And they do.

I get a breast MRI once a year.  I even changed health systems within the last two years and they will continue the same plan which is a relief.

In my initial visit with the oncologist, he did discuss prophylactic breast removal.  Yes...prophylactic...like "condoms" because it's for prevention of something.  I have stayed as up to date as possible on breast cancer research so I knew then that some people chose the double mastectomy, but I also knew that it wasn't for me.  My doctor's opinion is that it's an aggressive option that does have benefits, but that it's not the be all end all option and should be a personal choice.

It's not that I don't debate it.  I do.  And I definitely think that my opinion is affected by the fact that my mother and aunt both survived breast cancer.  Angelina Jolie's mother did not.  And I think that is really meaningful.  Breast cancer is a little different in every person and my family members with my mutation had very good outcomes even when the cancer was not found right away.  (My mom was Stage 2, but the worst level within Stage 2).

I will continue to read and research and consider my options.  But for now, I feel that diligent monitoring is the best course of action.  Treatment has come such a long way, so even if I do get breast cancer one day, I believe that I can have it treated successfully too.

Ovaries are a different issue.  It's much more difficult to diagnose Ovarian Cancer so it's most often found at a later stage which causes it to be more deadly.  I probably will have my ovaries removed some time in the near future.  It scares me for sure.  And I need to do research about how ovary removal affects hormones and all of that, but since I am done having children, I think it probably makes sense.

I read on another blog that anyone saying that Jolie's decision is ridiculous or awesome doesn't get it.  This is a personal decision. One she bravely decided to share with the world.  I respect her decision, but more so her talking about it.  I may change my mind, but for now, I am choosing to make a different decision.