“My Medical Choice” was written by Angelina Jolie and published by the New York Times on May 14, 2013. Thank goodness for Angelina’s interest in public health and education! In her essay, she publicly announced that she underwent preventive double mastectomy with immediate reconstruction because she is Breast Cancer Gene (BRCA1) positive. Her gene positivity places her at a high risk of developing breast cancer and ovarian cancer, on the order of 65% and 50%. Her decision to undergo double mastectomy was a “no brainer” for her. She knew she was at significantly increased risk for developing breast and ovarian cancer in the future, and she decided to improve her long term survival for the benefit of her family. She will undergo surgical removal of her ovaries in the future. As she shares, her mother died of ovarian cancer, so Ms. Jolie understands how bad the course of ovarian cancer can be.

I have had the good fortune of taking care of many BRCA+ women who were in Ms. Jolie’s shoes, who decided to undergo protective mastectomy procedures paired with reconstruction – I’ve also taken care of women who have novel gene + breast cancer, not BRCA, as more genes associated with breast cancer are being identified. Many of these women fall between the ages of 35 and 50 years of age, so this is a young cancer population. Many women wrestle with the decision about how to proceed if they test positively for the breast cancer gene. The key is finding a multidisciplinary team who specializes in breast cancer treatment to effectively discuss options. Angelina Jolie turned to a team of medical specialists and that is so important to properly gather all of the data necessary to determining each individual’s breast status, and what treatment modalities are best geared to the disease process. Angelina Jolie made a great decision for herself, but that might not be the recipe for success for everyone. I applaud Ms. Jolie for her candor, and for making the conversation on Gene Positive Breast Cancer a more public one.

If you have questions about your options for breast cancer reconstruction, please contact Dr. Michele Shermak at 410-616-3000

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