Cancer Prevention & Genetic Risk-- The Angelina Jolie Story
- Actress Angelina Jolie, 47, is thriving in her role as mother, ten years after she got a preventative mastectomy, due to being at an elevated risk of developing breast cancer.
- Jolie’s mother passed from breast and ovarian cancer in 2007. She carries the BRCA1 gene, which greatly increases her risk of developing breast cancer.
- Jolie opted for a preventative double mastectomy to drastically reduce the chances of her getting diagnosed with breast cancer.
- Women who are found to test positive for a genetic mutation really have two options, say experts. 1) High-risk surveillance, which means getting checked every six months or so with mammograms and MRIs. But that's not prevention, that's early detection. 2) To prevent breast cancer entirely unfortunately, the only way to do that is to remove the actual tissue at risk and that is the breast tissue
This week, Jolie and her daughter Zahara Jolie-Pitt, 18, stepped out in New York City looking chic and glamorous together.
Jolie & BRCA1 and BRCA2 Gene Mutations
Jolie underwent genetic testing, which showed that she carried the BRCA1 gene mutation, which put her at a higher risk of developing breast and ovarian cancers. The actress pursued genetic testing as a result of her mom’s cancer diagnosis.
Famously, the Maleficent actress penned a powerful OpEd in The New York Times in which she wrote about her decision to get a preventative double mastectomy. Because of this mastectomy, she vastly reduced her chances of getting breast cancer.
Thanks to her openness about her preventative decision and her genetic testing, this kind of testing increased, potentially saving an untold number of lives to breast and ovarian cancer. It was dubbed "The Jolie Effect."
In an earlier interview with SurvivorNet, Dr. Rebecca Arend, an Associate Scientist at the University of Alabama-Birmingham, explains the BRCA mutations. “What a BRCA mutation is is it’s a defect in your ability to repair a double-strand break. If you think about DNA being a double helix, that we’ve all learned about in basic science, if you have a single-strand break, a PARP enzyme is needed to repair that single-strand break. If you have a PARP inhibitor, then you can’t repair that single-strand break,” she says.
Dr. Arend continues, “And if you have a single-strand break that’s not repaired, that actually leads to a double-strand break. So when both of the arms of the DNA helix are broken, then your body has normal mechanisms for repairing that. One of them is called homologous recombination.”
She explains how this is the body’s normal way of repairing a break. “But if you have a BRCA mutation, you actually cannot repair that break.”
Jolie’s Preventative Double Mastectomy
Jolie opted for a preventative double mastectomy to drastically reduce the chances of her getting diagnosed with breast cancer.
In an earlier interview with SurvivorNet, Dr. Elisa Port, Chief of Breast Surgery at Mount Sinai Health System, spoke about double mastectomies. Dr. Port explains the procedure, saying, “A double mastectomy typically takes about two hours for the cancer part of the operation, the removing of the tissue, the real length, the total length of the surgery can often depend most on what type of reconstruction she has.”
Dr. Port continues, “Most women who have removal surgery of both breasts do have reconstruction.” Dr. Port says that the time for the reconstruction varies greatly. “With implant-based reconstruction, it can take two to three hours, so the total surgery is four to five hours.”
She says that an alternative reconstruction involves a person’s own tissue typically from the belly which is then used to reconstruct the breast.
Dr. Port says, “When you take tissue from another part of the body and transfer it to fill in the empty space where the breasts are, this is a very long operation. It can take anywhere from six to 12 hours because it’s really like having a tummy tuck and then transferring the tissue and grafting the tissue, connecting the vessels.”
She adds that it’s not only a longer operation but that the recovery time is longer, too. Dr. Port explains how the type of reconstruction a person has informs the recovery period.
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