I applaud Angelina Jolie's candid approach to her recent
treatment for breast cancer. Because of
her “star” status, she is able to put a significant spotlight upon current
issues in breast cancer treatment today. This includes the BRCA gene, which places her
at high risk for breast cancer, that many people may not know much about. It also highlights her approach to this
situation with her getting prophylactic
bilateral mastectomies and immediate breast reconstruction with tissue expander
implants.
Many people may wonder why someone would want to undergo
bilateral mastectomies at this stage of her life while not actually having
breast cancer but having a high risk gene.
She explains it quite well: she
wants to decrease her chances as best as possible, even at the cost of losing
her breasts. The complete removal of the breast tissue (mastectomy)
early on decreases the chances for breast cancer significantly in the future. In the
meantime, she can undergo breast reconstruction which will still allow her to have
excellent breast aesthetics. By
undergoing prophylactic mastectomy with nipple preservation, she will also
avoid any radiation treatment which can severely deform the breasts--radiation
has its own set of problems including wound issues, implant infections, contracture,
radiation changes to the heart and lung.
The other option that she may have considered is autologous
breast reconstruction using her own tissues without an implant. This includes the
DIEP breast flaps from her abdomen transplanted to her chest via microsurgical
technique which would preserve her “super six pack.” This would allow her to have breast
reconstruction at the same time with her own tissues and would get a potential tummy
tuck as well. My guess is that Angelina Jolie did not have
enough abdominal tissue to undergo bilateral breast reconstruction and that is
why she chose tissue expander and implants.
She will need to undergo several expander injections and another
operation for a final silicone implant.
It is very common now for me to see patients who seek to
undergo prophylactic mastectomies and immediate breast reconstruction. It allows the patient to be treated at an
earlier stage stage in a proactive
way, based on genetic information or early
diagnosis. Our team of breast surgeons, oncologists,
pathologists, and plastic surgeons can treat women in the same, proactive way
that Angelina Jolie sought with outstanding results.
I thank and applaud Angelina Jolie’s courage in sharing this
deep and personal part of her life to help others. She is a super star in my book.
