Angelina Jolie has double mastectomy due to cancer gene

 

The BBC's Fergus Walsh explains the background to Angelina Jolie's decision

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Hollywood actress Angelina Jolie has undergone a double mastectomy to reduce her chances of getting breast cancer.

The 37-year-old mother of six has explained her reasons for having the surgery in the New York Times.

She said her doctors estimated she had an 87% risk of breast cancer and a 50% risk of ovarian cancer. "I decided to be proactive and to minimise the risk as much I could," she wrote.

Her partner, Brad Pitt, praised her choice as "absolutely heroic".

Risk reduced

Ms Jolie said the process began in February and was completed by the end of April.

In an article entitled My Medical Choice, she explained that her mother fought cancer for nearly a decade and died at the age of 56.

Family history of breast cancer

  • About one in five women diagnosed with breast cancer will have a significant family history of the disease
  • Having close family members - first-degree relatives like a sister, mother, aunt or uncle - with breast cancer raises a woman's own risk of the disease
  • Certain genes such as BRCA1 and BRCA2 are strongly linked with breast cancer and can be detected with genetic tests
  • Women carrying the BRCA1 mutation have up to a 65% chance of developing breast cancer by the time they are 70
  • Fewer than 1% of women are at high risk of developing breast cancer
  • Another 2% of women deemed to be at moderate risk might also benefit from taking preventive breast cancer drugs for five years, say experts

She said she had sought to reassure her children that the same illness would not take her away from them, "but the truth is I carry a 'faulty' gene, BRCA1, which sharply increases my risk of developing breast cancer and ovarian cancer".

She said that once she "knew that this was my reality", she had taken the decision to undergo the nine weeks of complex surgery required to have a double mastectomy, followed by reconstruction of the breasts with implants.

"There have been many advances in this procedure in the last few years, and the results can be beautiful," she wrote.

Dr Kristi Funk said she hoped Angelina Jolie's choice would help raise awareness around the world

Her chances of developing breast cancer have now dropped from 87% to under 5%, she said.

She praised her partner, actor Brad Pitt, for his love and support throughout the procedure, and said she was reassured that her children had found nothing in the results "that makes them uncomfortable".

"I feel empowered that I made a strong choice that in no way diminishes my femininity," she said.

"For any woman reading this, I hope it helps you to know you have options," Ms Jolie went on to say.

"I want to encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices."

In an interview with the Evening Standard, Brad Pitt said: "Having witnessed this decision firsthand, I find Angie's choice, as well as so many others like her, absolutely heroic.

"All I want for is for her to have a long and healthy life, with myself and our children. This is a happy day for our family."

Ms Jolie, an award-winning actress and director, is also a long-time supporter of humanitarian causes. She is currently a special envoy for the UN Refugee Agency.

During the period she was undergoing the double mastectomy procedure, Ms Jolie visited the Democratic Republic of Congo with UK Foreign Secretary William Hague and attended the G8 summit of foreign ministers in London to raise awareness over sexual violence in conflict.

She also helped launch a charity to fund girls' education set up by the Pakistani schoolgirl activist Malala Yousafzai, who survived being shot by the Taliban last October.

Ms Jolie has three biological children and three adopted children.

Risk factor

Emma Parlons, a 38-year-old mother from London who had the operation three years ago, welcomed her decision to raise awareness of the issue.

Emma Parlons: "If somebody said your flight was 86% likely to come down, you wouldn't get on that plane"

Ms Parlons said her risk of getting breast cancer was the same as the actress's. "If somebody said your flight across the Atlantic was 86% likely to come down, you wouldn't get on that plane would you?" she said in an explanation of her reasons for having the operation.

Professor Gareth Evans, of the Manchester Breast Centre in Britain, said the two genes BRCA1 and BRCA2 (breast cancer one and two) "were the first two majorly breast cancer pre-disposing genes that were identified" and are also linked to an increased risk of ovarian cancer.

Angelina Jolie

  • Born in 1975 to actors Jon Voight and Marcheline Bertrand
  • Has spoken of a troubled childhood, in which she self-harmed and took drugs
  • Won an Oscar for best-supporting actress in 2000
  • Has visited conflict zones and raised awareness of refugees and sexual violence
  • Granted honorary citizenship of Sarajevo for 2011 film about Bosnian war
  • Has three adopted children and three biological children with partner Brad Pitt

"The risk associated with the genes isn't simply an exact figure like 87%," he told the BBC.

"It does depend on other risk factors, and so the risk for someone with a BRCA1 mutation could vary anywhere between 50 and 95% for breast cancer."

Currently, women facing a strong likelihood of developing breast cancer have only two real options - to have both of their breasts removed (a double mastectomy) or hope that it will never actually happen.

In January, the drugs watchdog in England and Wales, the National Institute for Health and Clinical Excellence, recommended women at a high genetic risk of breast cancer should be given the option of taking the drug Tamoxifen, or another one called raloxifene, for five years to cut their lifetime risk of the disease.

 

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  • Comment number 273.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this
    -11

    Comment number 272.

    Why is this the most popular new story? Surely it isn't cancer avoidance, as there are much more appropriate stories to be told. Leading by being a published example; there must be other ways. What next, a male celebrity coming out about how his colon cancer test went, in detail. Celebrity interest? Boobs R Us? Jeez!

  • Comment number 271.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this
    +2

    Comment number 270.

    204 Douglas Stanhope
    You are attributing something to me which is not my comment; if you read the comments properly you'd see I am pro-medical intervention in cases like Ms Jollies & like you, get riled by people who think lifestyle choices can prevent genetic cancers.
    It was someone around 190ish @ rocketscience who made the comment about the power of nutrition to apparently conquer all.

  • rate this
    +5

    Comment number 269.

    Pre-emptive surgery is a big step, particularly when it involves a part of your body which might be conflated with identity. I'm not convinced the media carnival that will follow a Jolie breasts story will be 100% of benefit to others in similar situations. Respect and caution are to be encouraged.

  • rate this
    0

    Comment number 268.

    63.
    jayruth
    4 Hours ago

    15.ichabod
    I wish the media and charities would devote a fraction of the time they spend on Breast Cancer to ... Prostate Cancer, which....

    BS.
    ---
    I think what this person is saying is that the media appear to promote these cancers more, I'm not sure you can surmise how much or little they do themselves regarding these issues, perhaps you can enlighten me?

  • rate this
    +2

    Comment number 267.

    I admire Angelina for doing this it must have been very traumatic to find out and have the surgery. I hope she gets over this quickly. Often the physical effects of surgery are not a problem to overcome but the phsycological ramifications of this will probably take years to come to terms with. On another point is it just me but I think the guy from Cancer research UK looks like Donald Sutherland.

  • Comment number 266.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this
    0

    Comment number 265.

    My sentiments exactly. What a fortunate woman your wife must be.

  • rate this
    +3

    Comment number 264.

    As hard a decision as this is, I believe she made the right choice faced with those odds.

  • rate this
    +4

    Comment number 263.

    She has made a tough choice for a woman, regardless of her status. She put health over image, the correct choice every time. I admire and feel sorry for her at the same time.

  • Comment number 262.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this
    +3

    Comment number 261.

    I fully support Ms Jolie's decision. It cannot have been easy for her. I have a close friend who has battled breast cancer for the past two years with chemo, radiotherapy and although has won this time, she has been told there is a very high possibility it will come back, she has the defective gene, had she known, she would have done the same.

  • rate this
    +6

    Comment number 260.

    Two very brave decisions - Having the surgery and then going public. Perhaps an inspiration to other women with the same family history.

  • Comment number 259.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this
    +6

    Comment number 258.

    @90 - how about screening? what if you predict 90% chance of brain cancer or bone cancer?

    This IS screening.

    The difference is that you can substantially lower the risk with an acceptable treatment (to some people), otherwise there's no point in screening - you can't remove all of someone's bones, or their brain, but you can remove their breasts.

  • rate this
    +6

    Comment number 257.

    The point of Angelina going public isn't to advocate that all women should do this, but rather that it should be a respected choice. Society is so caught up with women's bodies/appearance, even to the detriment of their health, that people are still squeamish about her decision even though she faced the likelihood of death. If you had two bombs strapped to your chest, wouldn't you cut them off?

  • rate this
    +7

    Comment number 256.

    @247.

    It should not be brushed aside, no.

    But an 87% chance means that, unless you are lucky, sooner or later an MRIs is going to show cancer.

    Then you not only have the mastectomy but also radiotherapy and chemotherapy. Chemo carries other risks like heart damage (depending on the drug). This all may happen when you are older and less physically able to recover.

  • rate this
    -15

    Comment number 255.

    MONEY MONEY MONEY

    Yes, everyone's a winner.

    Hospital cha-ching !!!

    Big pharma-cha-ching !!

    Surgeons-cha-ching !!

    Breast implant companies-cha-ching !!

    Forget about prevention, Operations are good for the economy-cha-ching !!!

    Your partner is supportive when you want to cut your legs off - cha-ching !!!

    That's love - cha-ching !!!

    Plastic people.
    Plastic values.
    Plastic love.

  • rate this
    +5

    Comment number 254.

    I have total respect for Angelina for going public and hopefully people will be more aware of their choices which may save lives. Some times symptoms don't show themselves until it is too late, which happened to a friend of mine, who, after a long battle, many ups and downs and despite having a double mastectomy, succumbed to this awful disease last week. :-(

 

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