Angelina Jolie- double mastectomy

am i understanding this right that all the tissue from the breasts gets removed and then replaced with an implant or do the nipples have to be removed aswell? Either way it must have been a horrible decision to make and i think i would have done the same if i was a woman. I guess it would be like being told i had 85% chance of testicular cancer and had to get them removed. :frown:

She isn't choosing health over vanity. She can have both. She's probably actually getting an upgrade here. She's also had a bunch of other cosmetic surgery.

I was also just reading this:

"But some doctors also expressed worry that her disclosure could be misinterpreted by other women, fueling the trend toward mastectomies that are not medically necessary for many early-stage breast cancers. In recent years, doctors have reported a virtual epidemic of preventive mastectomies among women who have cancer in one breast and decide to remove the healthy one as well, even though they do not have genetic mutations that increase their risk and their odds of a second breast cancer are very low."

You do know that this is a non sequitur, right?

Besides, what business is it of yours if a woman who has cancer in one breast decides to remove them both? And there's no "epidemic" of women running off and removing their breasts. If a patient, a doctor, and an insurance company decide it is appropriate, then it is. Most women aren't paying out of pocket for this, and a decision to cover this type of surgery is based on "medical necessity." If it is approved, then it is because the doctor declared it to be medically necessary.

By "some," most journalists usually mean one doctor they hunted down who is an outlier or who simply wants to play devil's advocate. Having spent a whole lot of time in rooms with surgeons and oncologists on what types of surgeries are and are not medically necessary, it's just not as big an issue as you're making it out to be. Besides, nearly every health insurance policy available in the United States has a Prophylactic Surgery clause that defines what is and isn't considered medically necessary. Cancer in one breast, even with a low recurrence, is almost always covered because it is better for the woman and the insurer to have this done before there is a problem (and there are formulas that aid in making this determination). Chemo, more surgeries, and all related care for treating a cancer patient is very expensive. Treating a recurrence, where the doctors can't use the same chemotherapy protocol as the first time because it won't work and will do more harm than good, is even more expensive. Besides, metastasis with recurrence is the biggest issue. If a woman gets breast cancer again, oftentimes, it's in her bones, lungs, and brains. When that happens, were talking 5-15% chance of survival with the best of care. People can live just fine without breast tissue.

I say leave those decisions up to the doctor treating the woman, not some random outlier who wants to play devil's advocate.

ETA: Anyone who calls bilateral mastectomy an "upgrade" has no idea what it entails or even looks like to have silicone instead of breast tissue. This isn't a boob job where an implant is used to make breast tissue look better, this is removal of all soft tissue from the area, shoving a ball of silicone between two muscle layers in the chest wall, and then doing the best you can to have fat grafted around it to make it look somewhat normal. Fat grafting doesn't always take, so you spend the rest of your life looking like someone stuck a couple grapefruits under your skin. And when you flex your muscles or do any heavy lifting, they look horribly deformed. Did I mention the complete loss of sensation in the chest wall? That doesn't come back. All the nerves are severed, except the bundle that runs down your sternum, and those hurt almost constantly for the first year. For some women, it aches for life.

That's the reality of this "upgrade."

I'm not Angelina Jolie, but here's my story:

I was diagnosed with breast cancer 3 months after I turned 37. Everything happened very quickly and ten days after my diagnosis I had a lumpectomy. I was extremely lucky and my breast cancer was Stage 0 (DCIS) and was non-invasive and contained in the ducts.

Following my lumpectomy, but before my radiation therapy, I was given the BRCA test because my father's sister was also a breast cancer survivor. I tested positive for the BRCA II gene.

Six months after I completed my radiation I got pregnant with my post cancer miracle baby (today is his 1st birthday)...I am currently in the process of preparing for a double mastectomy with reconstruction. Not only are my chances of reoccurrence very high but I was not a candidate for tamoxifen because I also carry the Factor V gene (blood clots). Living in fear of cancer returning is not fun and although I was very lucky with my first diagnosis, I may not be so lucky in the future. I have 3 beautiful boys that I need to be here for and if that means heading back to the OR then that's what I'm going to do.

Good Luck . x

Thank you

I'm extremely nervous but I know that it's absolutely the right thing to do. They will test my boys for the gene when they reach their teenage years (my great grandfather had breast cancer)

am i understanding this right that all the tissue from the breasts gets removed and then replaced with an implant or do the nipples have to be removed aswell? Either way it must have been a horrible decision to make and i think i would have done the same if i was a woman. I guess it would be like being told i had 85% chance of testicular cancer and had to get them removed. :frown:

There are many types of reconstruction available...not sure which one she chose

She chose bilateral nipple-sparing. She was able to keep her nipples, but all of the breast tissue is removed from under the nipple and within the nipple. Necrosis can happen, which is why she had tests for blood flow to the area to see if she was a candidate.

Nipple sparing is fairly new. Most women have to get the nipples removed and rebuilt. I've seen rebuilt nipples that have been attached in a subsequent surgery and then tattooed for color. They look surprisingly real.

I'm not Angelina Jolie, but here's my story:

I was diagnosed with breast cancer 3 months after I turned 37. Everything happened very quickly and ten days after my diagnosis I had a lumpectomy. I was extremely lucky and my breast cancer was Stage 0 (DCIS) and was non-invasive and contained in the ducts.

Following my lumpectomy, but before my radiation therapy, I was given the BRCA test because my father's sister was also a breast cancer survivor. I tested positive for the BRCA II gene.

Six months after I completed my radiation I got pregnant with my post cancer miracle baby (today is his 1st birthday)...I am currently in the process of preparing for a double mastectomy with reconstruction. Not only are my chances of reoccurrence very high but I was not a candidate for tamoxifen because I also carry the Factor V gene (blood clots). Living in fear of cancer returning is not fun and although I was very lucky with my first diagnosis, I may not be so lucky in the future. I have 3 beautiful boys that I need to be here for and if that means heading back to the OR then that's what I'm going to do.

Thank you for sharing this. Happy birthday to your miracle baby, and best of luck to you.

I kinda agree... but at the same time, she has the means to do it and get reconstruction right away. Since it is an elective surgery not covered by insurance, most women won't be able to follow suit.

I would do it in a heart beat, and end up with better boobs.. hell yeah.. but I couldn't afford it or the time off of work to recover or the childcare/household help I would need.

This...even though it's amazing that she made such a brave choice, she does have the means to fix it and visually not have much of a change. Most insurance companies don't cover reconstructive/cosmetic surgery. It can be damaging to one's self esteem and self perception.

Again, if it's medically necessary or if you're in a situation like this where you know you're changing your risk significantly, it's appropriate and probably recommended...but her brave choice seems a little less so when you know she can have it fixed almost immediately.

With a grandmother that died of breast cancer and a mother who is a 5 year survivior, I commend Jolie for her decision. Since both were diagnosed in menopause, my risk is like everyone elses, but even though I saw how horrible all the surgeries were on my mom, to prevent having to go through treatment, if I found out I had a 87% chance I'd do the surgery in a heart beat. Chemo and Radiation is no joke.

And all of you that are acting like this isn't a big deal and she's rich and blah, blah, blah. Best doctors, blah, blah, blah. She's rich, yes. But it's still a hard decision to have to make. Insurances are required to cover mastecotomys (elective or not) and restruction, so the average person, if they found a great surgeon could have the same benefits as her.

I kinda agree... but at the same time, she has the means to do it and get reconstruction right away. Since it is an elective surgery not covered by insurance, most women won't be able to follow suit.

True. But, she also mentions that very thing in her article. Not only do applaud her for being proactive with her health . . . I also commend her for using her celebrity to create awareness in an effort to help other women who do not have the same resources she has.

MB

As a woman who is scheduled for a double mastectomy next week, I applaud Angelina for going public with her difficult decision. While my surgery is not prophylactic but the cure for my cancer, at age 39, I would choose life over boobs anytime! Go Angelina!!!!

hugs to you and a huge wish for a speedy recovery and successful outcome!

I know too many women that simply believed in God and stayed faithfull to his word and were healed of multiple types of cancer for me to think this is admirable in any way or even the right choice. I's choose God's healing grace anyday before I choose to go under the knife just becuz I COULD get it not even ACTUALLY having it. This is just craziness but thats expected from Ms. Jolie.

My aunt chose this path as well. She died when she was 45. I miss her everyday.

I would say I'm sorry to hear about your Aunt my truth is she is probably looking down on us feeling sorry that we can't be there with here celebrating our Lord with street made of gold. She made that right choice bcuz even if she had made the choice to have surgery there is no way to know if she would still be here. She put her lifeis God's hands and felt it was time for suffering to be over and now she gets to spend everyday with him free from paind and strife and struggle. Don't get me wrong I've known women to die from this too and yes it hurts bcuz we want our loved ones here with us but really its a selfish nature thats makes us feel that way even if it is a loving kind of selfish...the best choice a person can ever make is to have faith and trust God completely even when its hard....that was the real point I was making.