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Sunday, May 27, 2018
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Jolie praised for writing about double mastectomy

Angelina Jolie's physical presence has always turned heads, but the announcement today that she recently underwent a preventive double mastectomy grabbed worldwide attention.
The Oscar-winning actress, regularly named one of Hollywood's most beautiful, said she decided to undergo the surgery after learning she carried a gene making it extremely likely she would get breast cancer.
She opted to remove both breasts: the most extreme and most effective way to reduce future cancer risk. Jolie, 37, wrote in the New York Times she made the choice for her six children and after watching her own mother, actress Marcheline Bertrand, die too young from cancer.
“My mother fought cancer for almost a decade and died at 56,” said Jolie, the longtime partner of actor Brad Pitt. “She held out long enough to meet the first of her grandchildren and to hold them in her arms. But my other children will never have the chance to know her and experience how loving and gracious she was.”
She wrote that, “They have asked if the same could happen to me.”
Between early February and late April, Jolie completed surgical procedures to remove both breasts and reconstruction. She said she wrote about her experience hoping to help other women.
“I wanted to write this to tell other women that the decision to have a mastectomy was not easy. But it is one I am very happy that I made,” Jolie wrote. “… I can tell my children that they don't need to fear they will lose me to breast cancer.”
Jolie said that after genetic testing she learned she carries the “faulty” BRCA1 gene and had an 87 percent chance of getting the disease herself.
In general, individuals with a BRCA gene mutation face a 60 to 70 percent average lifetime risk of breast cancer, said Tuya Pal, a clinical geneticist at Moffitt Cancer Center in Tampa. The risk for the general population: just 8 percent.
Susie Goldenberg was 38 when she was diagnosed with breast cancer in the early 1990s -- about the same age her maternal grandmother was when she died of the disease. There was no genetic test for her to take, no name for the now familiar BRCA gene, and she felt mostly alone in making her treatment decisions.
“I grew up knowing there might be a heredity risk,” she said.
The Tampa resident is thrilled Jolie is bringing attention to genetic testing, something Goldenberg does as an outreach coordinator of the hereditary breast and ovarian cancer support group called FORCE, or Facing Our Risk of Cancer Empowered.
The group educates women at high risk for these cancers about genetic counseling and testing, and about the different treatment options available.
“It gives them the opportunity to ask questions and look at all the alternatives available to them,” Goldenberg said of the group, which includes extensive online resources and quarterly gatherings.
For women with the gene mutation, undergoing a double mastectomy can reduce the lifetime risk of breast cancer by 95 percent, but is not the only alternative, Pal said. Chemotherapy-like medical treatment, and regular mammograms and MRIs also can be effective in helping women and men with the genetic mutation monitor their risk, she said.
“When you have counseling, you can make an informed decision,” she said.
Genetic testing is becoming far more common, and some insurance companies now cover the roughly $3,000 cost to test for the breast cancer gene mutation.
That ability to better inform women and men about their risk is the focus of a $2.8 million grant issued last week to the University of South Florida. The five-year study will track 5,000 breast cancer patients nationwide who have Aetna health insurance.
Jolie isn't the first celebrity to share her medical decision to have a preventive mastectomy. Other celebrities, such as Christina Applegate, have shared decisions they made based on the two-decade old genetic testing. But Jolie, whose roles include idealized sexual characters such as Lara Croft, is by far the most famous.
“I do not feel any less of a woman,” wrote Jolie, who also is known for her charitable work as a United Nations ambassador. “I feel empowered that I made a strong choice that in no way diminishes my femininity.”
Pitt, her partner of eight years, was at the Pink Lotus Breast Center in Southern California for “every minute of the surgeries.”
“Having witnessed this decision firsthand, I find Angie's choice, as well as many others like her, absolutely heroic,” he said in a statement released to London's Evening Standard.
Jolie's decision raises awareness and empowers others to ask questions about their breast and ovarian cancer risk, Goldenberg said. Now is the chance to be educated, she said.
“It's important women can get together and feel comfortable talking about this,” she said. “It's important to know you are not alone.”

Information from the Associated Press was used in this story.

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