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More about Angelina Jolie and Choices

Posted 5/15/2013

Posted in

  I sort of feel that I should apologize for continuing the conversation about yesterday's big news regarding Angelina Jolie's choice to have bilateral prophylactic mastectomies. However, it is very clear from the continuing deluge of news articles and all the emails that I have been receiving that this is still very much on our minds. The women whom I know, virtually all of whom have had breast or ovarian cancer, have had strong and mixed opinions about her decision. They have been honest and self-aware about their reactions--one of my favorites was one woman, a nurse, who chose this same surgery after a breast cancer diagnosis. She said that, although she knows it is very trivial, she is bothered by the "double mastectomy" phrase that is so often used. As she commented, there is no such thing as a "triple" mastectomy.

  There have been very thoughtful news pieces and blogs, and others that have been sensational and definitely not helpful. Sanjay Gupta, MD, writing for Medpage, talked about the reactions of some oncologists, the differences between academic medical centers and places like the one where Ms Jolie was treated (which actually may not exist in great numbers in other parts of the country):

  Another essay in The Wall Street Journal includes a lot of good information and context about breast cancer in general and hereditary breast cancer (BRCA1 and BRCA2) in particular. It also speaks to the issue that I wrote about yesterday, the possible surge in requests for genetic testing from women who don't need it. Here is a quote and a link:

"Women should be empowered by family-history knowledge and BRCA knowledge," said Isabelle Bedrosian, a breast surgeon at MD Anderson Cancer Center in Houston. But a clear family history should be determined before getting tested, she said.

Tests for both BRCA mutations are marketed by


Myriad Genetics Inc. of Salt Lake City, which said such testing costs about $3,340. It is covered by major health insurers and managed-care organizations in the U.S., although generally only when women have a significant family history of breast or ovarian cancer.

    My strong favorite, so far, is Heather Millar's piece from Web MD. Here is a quote and a link to read more:

Let’s unpack all this. First, here are the things to admire about Jolie’s actions and her opinion piece:

• Jolie has proved once again that she is not your average movie star-director. She’s thoughtful and intelligent; she seems to have written this op-ed herself. She seems committed to making the world a better place. She doesn’t shy away from the hard choices.

• For all her smarts, Jolie is a sex symbol. Now, she’s a sex symbol who’s had her breasts cut off and reconstructed. Apparently, society is still willing to consider her a beautiful woman. That’s awesome. Truly.

• Jolie did not let this become a tabloid circus. She broke the news herself in what is arguably the nation’s newspaper. Bravo.

• She’s got people talking about breast cancer. My husband tells me I live in a bubble, that not everyone is comfortable talking about breasts or cancer, let alone those two things together. OK, I’ll allow that that’s probably true. There’s still a lot of fear and ignorance out there, so thanks Ms. Jolie for starting this discussion.



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