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Michelle McBride on the backlash from Angelina Jolie’s recent op-ed

Michelle McBride

Michelle McBride

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Updated: June 23, 2013 6:22AM



Last week, in an op-ed piece in the New York Times, Angelina Jolie revealed that she had a prophylactic mastectomy after learning she’d inherited a gene mutation that gave her a high risk of developing breast cancer. Angelina shared her story in order to help others who might find themselves in the same situation, but many are claiming that she’s actually encouraging women to have mastectomies. As someone who’s had the same surgery, and who now counsels others about genetic testing and the options that follow a positive genetic test, I’m worried this backlash may undermine Angelina’s good intentions.

For the record, here are her words:

“For any woman reading this, I hope it helps you to know you have options. 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.”

She goes on to acknowledge that there are alternatives to surgery, but never once suggests that it’s a one-size-fits all solution for women, or even for high-risk patients.

The fact is, high-risk patients don’t need to opt for surgery. Other options include a more rigorous screening regimen for breast cancer, including annual MRIs, annual mammograms and twice-yearly clinical exams. An annual blood test called the CA-125 may help detect ovarian cancer. There are also nonsurgical preventive methods, such as drugs like Tamoxifen or Relafin, which are known to reduce breast cancer risk by 50 percent when taken for five years.

That being said, I don’t want to downplay the significance of Angelina’s decision to have a preventive mastectomy. Despite public response insinuating that it was irrational for her to have a mastectomy when she was perfectly healthy, it’s an entirely appropriate option for certain BRCA patients.

Making the decision that Angelina and I made always has a backlash. After I learned that I had inherited a defect in the BRCA2 gene from my mother’s side of the family, I heard things like, “Sure, you have an increased risk, but if you get cancer, you can catch it early,” or “By the time you get cancer, they might have a cure.” Because they loved me, these doubters didn’t want to see me undergo such a grueling procedure — and believe me, neither did I. But like Angelina, I had an 87 percent chance of developing breast cancer in my lifetime. I didn’t want to “catch” the cancer early. I didn’t want to get it at all.

Following the surgery, I immediately questioned my choice — I was in pain, I didn’t yet feel whole. But when I went in for my post-op appointment, it turned out that I had cancer in my left breast that had previously gone undetected. The surgery got it all, and I needed no further treatment. At that very moment, every shred of doubt disappeared. Cynics beware: I now know with 110 percent certainty that having a preventive mastectomy was the right decision for me.

The important thing is to find out if you are at risk. Talk to your doctor. He or she can help you assess your risk and whether or not genetic testing is appropriate for you. It doesn’t mean you have to have surgery. That’s just one weapon in the arsenal of cancer prevention for high-risk patients.

The bottom line is this: Angelina Jolie shared her story in order to help people. Don’t turn her good deed around on her. It’s a disservice to all of the women whom her message could save.

The Noreen Fraser Foundation is a nonprofit dedicated to raising funds for groundbreaking women’s cancer research. To learn more, please go to Noreen
fraserfoundation.org or Facebook.com/noreen
fraserfoundation.



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