Angelina Jolie and Her Breasts

Yesterday's big news was Angelina Jolies breasts. It is said that Jolie was tested for the breast cancer gene because her mother died in her 50's from cancer. Jolie found that she had the gene which gave her an 87% chance of getting breast cancer, so she opted for a double mastectomy and reconstructive surgery to lower her risk to less than 5%.

Message boards, Facebook and other social media were alive with public input on opinions of her actions. Some thought it was nothing more than a publicity stunt to amp up a stalled career. Last I knew her career was fine as she gets multi-millions if she chooses to do a film and if she chose never to do a film again.....I think her, Brad and their six kids would be just fine financially. Then there were those who felt that what Jolie did was extreme overkill feeling that she "mutilated" her own body out of fear. Of course there were those who have watched someone die from cancer or know that cancer is rampant in their family and they totally got why she did it. They too would do it if faced with the likelihood of breast cancer because of genetics. And finally....there were those who had no idea that there was a genetic test for breast cancer and that such pro-active measures could be taken to prevent the disease. So as you see.....one woman's actions (be it a high profile woman) set the media on fire and brought about water cooler conversation for days to come.

Here's a little story that some of you may know but many of you don't. My mom had three primary cancers. What this means is that she had three distinctly different cancers and none of them were related. Often cancer from one place will spread to another making it a secondary cancer to the primary one, but in Mom's case....they were all primary. She began with uterine cancer, had a full hysterectomy and was fine. Then they found that her breasts were full of what they called "pre-cancerous" areas. Having been terrified when she learned of her uterine cancer....she did her research on what she could do to prevent the inevitable breast cancer that was in her future. This was about 1998 or so and cancer then like now......was without a cure and then we didn't even have what we have now in cancer treatment. When she found that she could have both her breasts removed.....she didn't think twice. Having this surgery when she was healthy and when it was her choice rather than wait until she "did" get breast cancer and run the risk of the cancer spreading was a no brainer for her. At the time insurance did cover the procedure as preventative (especially since her breast were pre-cancerous) but reconstruction was not covered. Her doctor strongly recommended reconstruction but Mom wasn't sure. At first she really didn't think reconstruction was a big deal. Several people in her life seconded that saying that reconstruction was nothing but vanity. After careful thought though....Mom decided that reconstruction was necessary for her as a woman. Those breasts had been a part of her for 60 years and losing them completely was not something she was ready to do. It was a decision she never regretted! Long story short....her surgery was covered....her reconstruction was not. Before even being completely healed....my mother and several other women who had also had the procedure done, went before the Kansas State Insurance Commission and explained why this surgery and the reconstruction were so important to women. Apparently they got through to the Commission as it was immediately covered. Mom did go on to have two other primary cancers (lung and colon) and sadly the colon cancer is what she died from in 2002. It was felt that my Mom's Lupus which she had lived with for over 40 years and possibly her ecosystem growing up on a farm full of DDT and other chemicals we now know to be cancer causing agents, could have played a part in all of this.

Mom was not alone in her cancer issues as several of her brothers and sisters also had cancer. The only two they had though were breast and colon, so quite possibly Mom's 4 pack a day cigarette habit for 30 some years had something to do with her lung cancer and the Lupus possibly aggravated it all. However....with a family history like mine, you have to know that I have always lived with the possibility of getting cancer in the back of my mind. My chances for uterine/cervical cancer diminished to almost 0 when I had a hysterectomy after David was born. I was hemorrhaging and it wouldn't stop. They wanted to leave my ovaries but my mother threw a fit and said I really needed to have a full hysterectomy where they took everything. I will thank her forever for having me do that. I found out though that because not only did my mom have pre-cancerous breasts and a couple of aunts as well as a couple of first cousins having breast cancer......I also had an uncle with breast cancer. That is pretty rare and when they see this in a family history.....it waves all kinds of red flags. My doctor strongly suggested that I start having breast exams every six months. In one six month period I have a breast MRI and in the next six month period.....a diagnostic mammogram. She also highly encouraged me to do genetic testing for the breast cancer gene. Because of my family history....I only paid $400 out of pocket for a $3500 test. The peace of mind finding out that I did not in fact have or carry the gene was worth every penny that I am still paying off. With my uncle having breast cancer though....I continue the bi-yearly exams as well as monthly self breast exams.

The bottom line about the breast cancer gene is that it takes an average chance of getting breast cancer (somewhere around 25%) and ups it to around 85-90%. As my doctor explained it to me.....if you have the gene then it quits being about "if" I get breast cancer and it starts being about "when" I get breast cancer. Then you live with "will I catch it in time?" Many people when faced with these percentages fall into denial and thus refuse to get the bi-yearly or even the yearly exams and opt to put their heads in the sand because they can't deal with the "C" word. My doctor explained the options to me when I was waiting for my genetic test results to get back (anywhere from 3-6 weeks). She told me that if I had the gene I could stick with the bi-yearly exams or I could have a preventative double mastectomy and reconstruction. I didn't even have to give it a second thought. My kids had already lost too much and too many people.....I wasn't about to make them lose me too. I also knew that anything that insurance did not cover was going to be a lot cheaper than cancer treatments.....and a six week recovery time is much easier than possible death. As with Mom....it was a no brainer. Fortunately.....I don't carry the gene and I am good with my bi-yearly exams. It is the smartest preemptive strike against this horrid disease and I am all about being one step ahead of the game where cancer is concerned.

To be quite honest....it is easy to see how people would view Jolie's actions as publicity stunts. For some actors/actresses.....this is what their lives are made up of and that is what we are growing used to from celebrity. However, Jolie doesn't usually jump into the media every time she changes her clothes. In fact....Jolie went through the surgery and reconstruction before she ever came out to the public. If it was just for the media attention.....she would have been proclaiming her actions from the get go....having the media follow her ever incision and suture. She did not. I would say Jolie came out about this to make women aware of the option....and she did. Many women didn't even know that there was genetic testing available or that even though this option is extreme that they could have an elective double mastectomy. A lot of people also came down on her because she was wealthy....therefore she could afford it where as the average woman cannot. I don't think this is necessarily true. Now I am not sure what is covered since Obama-care has come in and torn up the healthcare system....but before all of this, the surgery was considered preventative when you have the gene and with written recommendation from your doctor....both the surgery and reconstruction were mostly covered just like any other medically necessary procedure. Obama-care may have changed that. I truly hope not.

The bottom line....cancer is nothing to play around with. A wait and see attitude could be the difference between life and death if you have the gene. It is also important to note that if you have the gene....your daughters (and sons) have an even greater chance of having both the gene and the cancer...as well as your siblings. In this case....knowledge truly is power. Is this procedure extreme? As a woman I would say absolutely, but my peace of mind, my health and my life are far more important to me than my breasts. So before we nail Jolie to the cross and make her the poster child for media posturing and extreme medical procedures, lets take a look at the bigger picture. Jolie has opened a lot of eyes to breast cancer, the gene and the possibility of prevention. She has started a dialogue and because of this....woman may go to their doctors and ask questions which could result in many lives saved.  The choice is obviously an individual one that cannot be made without all the facts, but today because of Jolie and her announcement....a lot more women now know that they actually have a choice.