Actress Angelina Jolie has been inspiring to women in many ways. Most recently, she spoke candidly about having to “escape” an encounter with disgraced movie producer Harvey Weinstein and how she warned other women in the film industry to be wary of him. Years ago, Jolie shared another story of her struggles publicly — and went on to inspire so many other women to be proactive about their health.
In 2013, Jolie went public with her decision to undergo a bilateral risk-reducing mastectomy due to the fact that she had a BRCA1 gene, which significantly increases a woman’s risk of getting breast cancer, and hikes the risk for ovarian cancer as well. A recent study from Scientific Reports showed that the rate of women undergoing preventative mastectomies after Jolie went public with her decision to do so significantly increased.
Jolie, 46, is perhaps one of the most well-known “pre-vivors” in the world. A pre-vivor is someone who undergoes a preventative surgery, such as Jolie’s mastectomy, to reduce their cancer risk because they have inherited some sort of genetic vulnerability. With the availability of genetic testing, more people are able to learn of their inherited cancer risks. However, the decisions about what to do about those risks are never easy.
People who have a family history of breast or ovarian cancer should consider being tested for mutations, particularly if the relative was diagnosed with cancer before age 50. Jolie lost her mother to ovarian cancer at age 56. If you’ve been diagnosed with a BRCA mutation, there are steps you can take to lower your risk of developing cancer.
In a previous conversation with SurvivorNet, Dr. Freya Schnabel, the director of breast surgery at NYU Langone Medical Center, said that there are typically three options for women with an increased risk of breast cancer due to BRCA mutations: intensive surveillance, medications and surgery.
Surgery “is the option that will lower a woman’s risk of getting breast cancer as low as we can get it, because the strategy here is to do surgery to remove the breast tissue as completely as we can,” Dr. Schnabel said.
Dr. Freya Schnabel explains the options for women with a high risk of developing breast cancer.
If you know that cancer runs in your family or you are unsure of your family history, you should consider speaking to a doctor or genetic counselor about your genetic testing options.
While there are direct-to-consumer brands out there like 23andMe that are FDA approved, if you really want to assess your risk, you’re better off speaking to an expert.
Dr. Schnabel stressed that even if these tests find some sort of mutation or risk, it’s going to need to be confirmed in a lab before you can do anything about that risk.
“Even being FDA-cleared to do these tests, the advice that we have is that the results for something like a BRCA mutation are not actionable unless that test has been reconfirmed in an approved lab– CLIA, CLIA-approved lab,” she said.
The decision to have a body part removed, especially when a cancer has not yet developed, is naturally incredibly difficult to make.
In a previous chat, pre-vivor Erika Stallings spoke about how difficult it was to explain to people why she was having her breasts removed — but looking back on her own mother’s experience with breast cancer, she’s so glad she made the decision to have a double mastectomy.
“At the time, it was also just hard to tell people — to say, I don’t have cancer, I just have a super high chance of getting cancer,” she explained. “So, I’m going to have what sounds like a really radical surgery and I hope you will be supportive of it.”
Pre-vivor Erika Stallings explains her decision to undergo a preventative mastectomy.