Thursday, May 23, 2013

Is Angelina Jolie's double mastectomy the only route to breast cancer prevention?


The beautiful face of Angelina Jolie was printed across the media recently due to her announcement of “prophylactic” mastectomies.  Ms. Jolie tested positive for a gene BRCA1 which can increase a woman’s chance for breast cancer.  Ms. Jolie lost her mother at age 56 after a 10-year bout with cancer. 

Almost 232,000 new cases of breast cancer are diagnosed every year and 40,000 women die from it annually.  The two genes most commonly associated with breast cancer are BRCA1 and BRCA2.  These represent probably less than 10% of all breast cancers.  There are other genetic markers that can pre-dispose someone to develop breast cancer and some yet to be discovered.  

In short, there are multiple genetic markers for breast cancer but BRCA1 and BRCA2 are the most common ones studied.  They also have a link to ovarian cancer as well.  Having one or both of these genes raises a woman’s risk of breast cancer to about 60% in her lifetime, compared to a normal risk in the range of 8% to 12% for the general population.

Test for these genes costs around $3,400.00 and many insurance plans will cover it.  The route Ms. Jolie took was radical but understandable.  If someone has a strong family history of breast cancer AND tests positive for those genes, careful consideration for bilateral mastectomies should be entertained. 

As a board certified Fort Myers plastic surgeon, I believe the stronger the family history for breast cancer, the more one should consider this route.  Breast reconstruction following mastectomies is in most cases a safe, outpatient procedure.  

But, there are other, more conservative, options such as semi-annual mammograms with ultrasound, MRI or as some physicians believe, thermography.  Some patients may benefit from tomoxifin.  As always, other things a person can do to lower their chances of developing breast cancer is to lead a healthier lifestyle,  ie. no smoking, maintaining a healthy weight, limiting alcohol intake, exercising on a regular basis and a staying on a healthy diet.

In any event, if any signs of breast cancer active or prospective appear, get thee to a physician quickly for diagnosis.

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