Angelina Jolie, Double Mastectomies, and Hard Decisions

Recently, Angelina Jolie chose to have a double mastectomy because of a genetic mutation predisposing her to ovarian and breast cancer. One simply has to Google "Angelina Jolie mastectomy" to wade through a myriad of opinions from professionals and laymen about the foolishness or wiseness of her very personal decision.

W-a-a-a-y back on November 4, 2012 when I learned of my breast cancer diagnosis, my surgeon briefly mentioned the possibility of a double mastectomy.  She let me know that she greatly discourages all patients needing a single mastectomy from considering a double mastectomy. Since I was definitely "deer in the headlights" that afternoon, I blindly followed along with her thinking. Of course, over the next days and weeks, I thought about a double mastectomy many times, especially after reading what chemo and radiation would entail.  Why would I ever want to go through all this twice, if I could increase my odds of only going through it once by getting rid of both breasts at once?

The complicating factor with my case was that I did not have an over-expression of the HER2 gene -- the most genetic of the 4 main types of breast cancer.  Remember many posts back I talked about being "triple negative" -- the most aggressive type of breast cancer -- one of those negatives was for HER2.  Just to reiterate -- EXCELLENT news for my four daughters -- not quite such good news for me.

Preventative mastectomies are really only indicated when a woman carries the gene that predisposes them to breast cancer.  In my case, having a double mastectomy would have been an emotional decision to help my psychological peace-of-mind in the future.  It would NOT have been a medically-sound decision.

There is a far greater chance of my cancer reoccurring in the chest muscle, skin, or lymph nodes in my original cancer site, or of the cancer travelling to my liver, lungs, or bones than there is of the cancer "jumping" to the other breast.  My oncologist has told me several times that if cancer ever appeared in my other breast, there is a 99% chance it would be totally unrelated to my original breast cancer.

Now I understand more what my surgeon meant when she said she discourages double mastectomies in cases like mine.

Had I carried the gene, what would my decision have been??  What would my girls' decision have been once they learned the genetic predisposition at play in their bodies? That's almost impossible to say.  Does the age of the woman matter?  Some people have said a preventative double mastectomy was fine for Sharon Osbourne "at her age", but Angelina is a young woman and should never have done it.  Does marital status, children, where you are in your life matter?  Like so much else in life, it's an individual decision and how dare any of us say it is right or wrong!

Having lived through a single mastectomy and many, many other tests, scans, surgeries, pokes, chemos, etc. etc., the mastectomy was NOT the worst.  Far from it.  If a woman can do the rehab and recuperate fairly well from a double mastectomy, have reconstruction, and reduce her chances of breast cancer by 70-80%, all the power to her!!