angelina jolie in a dark blazer with confident look after double mastectomy
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A Patient’s Journey: Angelina Jolie

In an article in the New York Times today, My Medical Choice, Angelina Jolie promised to share some background about her medical treatment with women seeking more information about BRCA gene mutations and what it might mean for them. This blog describes the main stages of her treatment.

It is important to emphasize that each woman’s case is different. Surgery will not necessarily be the right choice for everyone, and there are alternatives available. As Angelina says in her article, the important thing is to be aware of your options.

STAGE 1. Gathering Data and Information

  • BRCA stands for BReast CAncer.  BRCA genes help you fight cancer when it happens in your body. But some families carry mutated or broken BRCA genes that can be passed down from one generation to the next. Approximately 5-10% of all breast cancers and 14% of ovarian cancers occur from a BRCA1 or BRCA2 genetic mutation that is inherited from either parent.
  • Women carrying BRCA1 or BRCA2 gene mutations have up to an 87% lifetime chance of breast cancer and 54% chance of ovarian cancer vs. a general population risk of 12% for breast cancer and less than 1% for ovarian cancer. Prevention does not yet exist. More details about the risks of breast and ovarian cancer, including how risk changes with each decade of life, can be found in our BRCA Gene Mutations blog post.
  • Given the high likelihood of getting breast or ovarian cancer with BRCA mutations, family history usually triggers testing for the gene. Angelina’s mother had breast cancer, and sadly passed away from ovarian cancer.  Her maternal grandmother was also diagnosed with ovarian cancer. This family history would certainly meet any insurance carrier’s criteria to cover genetic testing. To find out if there is enough risk for you to consider a BRCA mutation genetic test, we encourage you to take our Genetics Quiz that reviews a variety of information, including your family history.
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STAGE 2. After diagnosis: Traveling the Road of Surveillance

We follow a standard surveillance plan at our center for BRCA mutation carriers, which I used for Angelina:

Beginning at age 18, or 10 years younger than the youngest relative with breast cancer, every 3 months, you have breast imaging or an exam. An example plan follows:

  • Month 1:
    Mammogram (wait until 25 years old)
    Whole breast screening ultrasound (begin at 18)
  • Month 4:
    Clinical breast exam with a breast specialist
  • Month 7:
    Breast MRI, timed to menstrual cycle days 7-10 (day 1 is the day bleeding starts); Contrast Enhanced Spectral Mammography (CESM) for those who cannot have an MRI
  • Month 10:
    Clinical breast exam with a breast specialist
  • Every month:
    Self breast exams (cycle days 7-10). If you don’t know how to do a self breast exam, please watch our how-to video.

For those who prefer twice-a-year surveillance, we combine the imaging with clinical breast exams, and meet every 6 months.

Episode 1: Jessie When can I fly a Plane again?

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Dr. Kristi Funk’s new video podcast explores the thriver stories of women who have altered their lifestyles after a breast cancer diagnosis, emerging with a profound sense of purpose and passion afterwards.

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Jessie: When can I fly a Plane again?

Ovarian surveillance begins at age 35, or 10 years prior to youngest relative with ovarian cancer, and includes the following:

  • Transvaginal Pelvic ultrasound every 6 months (cycle days 1-10)
  • CA-125 blood marker testing every 6 months (after cycle day 5)
  • Pelvic exam by gynecologist every 6 months

For additional screening details, including risk reduction strategies and holistic and integrative medicine, see our blog on BRCA Gene Mutations.

STAGE 3. Committing to an operation

When first meeting a woman newly diagnosed with a BRCA mutation, my immediate goal is to learn about her, including her family situation, whether she is in a stable relationship, and whether she is planning to have children. In the course of these discussions, it becomes clear whether the patient will proceed to a mastectomy.

STAGE 4. Preparing for the operations

The questions any patient needs to address at this stage include: (1) whether or not to preserve the nipples, (2) if so, whether or not to perform a “nipple delay” procedure, (3) where to place the incision, (4) whether or not to test sentinel nodes, (5) what kind of reconstruction will be done, (6) what supplements might enhance healing and recovery, and finally (7) where should we operate.

NIPPLE: Women undergoing preventive mastectomies can always consider keeping their nipples. While no one can guarantee that the nipples will survive an operation, much can be done to ensure the greatest chance of success.

NIPPLE DELAY: The delay, performed 1-2 weeks prior to the actual mastectomies, uses the planned mastectomy incision and lifts half of the skin off of the breast surface. A small disc of the tissue directly behind the nipple and areola is also removed and analyzed by a pathologist. This is done to rule out the presence of any disease directly behind the nipples, which would make preserving them a dangerous proposition. Additionally, it recruits extra blood flow to the area, lessening the chances of nipple and skin loss due to insufficient blood supply after the mastectomy. Since starting this technique in 2008, my loss of skin and nipple after mastectomy has decreased to less than 2%. In Angelina’s case, she judged it worth taking this extra step of caution.

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INCISION: Incision locations must take into consideration a cancer location (if cancer is present), any prior incisions, breast size reduction (if desired), and the technical skill of the surgeon (smaller incisions make for a harder and longer operation). For Angelina, her optimal incision choices were around the areola, or underneath the breast in the inframammary fold – the latter was chosen.

SENTINEL NODE BIOPSY/PBDI: Whenever a breast contains cancer and the armpit lymph nodes cannot be felt on exam, we routinely perform a sentinel node biopsy, which is the removal of the first nodes that receive breast lymphatic drainage. By injecting blue dye into the breast, which then travels to the lymph node(s), we find out if cancer spread beyond the breast. Until now, the trend has been not to perform sentinel node biopsies in conjunction with prophylactic (preventive) mastectomies since the discovery of cancer in breasts removed prophylactically only ranges from 2-8%. Therefore, most women do not want to take the additional risks associated with a sentinel node biopsy, especially since they can have complications, such as pain, numbness, arm swelling (lymphedema), fluid buildup (seroma), limited arm movement, and infection. This dilemma has been resolved with a new technique that was pioneered at the Pink Lotus Breast Center, called Prophylactic Breast Dye Injection, or PBDI. PBDI allows the sentinel node to be identified, but not surgically removed, giving more control and peace of mind to women. I developed this technique while treating Angelina, and I hope other women will now benefit from it. It was at her friendly insistence that I wrote the rationale for it in our blog post, Prophylactic Breast Dye Injection.

RECONSTRUCTION: Reconstruction options vary depending on a number of factors.  The two broad categories of reconstruction include implants and flaps. Implants are the most common reconstruction, often requiring two stages, whereby a tissue expander is placed prior to the final implant. A tissue expander is a deflated implant that goes behind the pectoral muscles and gets slowly inflated with saline over a period of 2-3 months, until the chosen volume is reached. A second operation is performed to swap the expander for the final implant (usually silicone). A different implant option can be a “one-step” operation, where the final implant is placed at the time of mastectomy, skipping the expander phase.

Episode 1: Jessie When can I fly a Plane again?

Cancer-Kicking! PowWow

Dr. Kristi Funk’s new video podcast explores the thriver stories of women who have altered their lifestyles after a breast cancer diagnosis, emerging with a profound sense of purpose and passion afterwards.

Watch Episode 1
Jessie: When can I fly a Plane again?

Two improvements which I believe can enhance the final outcome for those patients choosing implants include: (1) the newly FDA-approved anatomic implants, which are teardrop shaped, and (2) allograft, or synthetic sheets of material, that create a more natural look.

Autologous flaps use your own skin, fat and sometimes muscle from the abdomen, back (latissimus), thigh (gracilis), or buttock to create a potentially more natural breast reconstruction than implants can achieve. Flaps, however, create scars at the donor site, potential weakness in the donor area, and involve a longer operation than implants, with longer recovery periods and associated hospital stays.

Angelina’s body type was best suited to an implant reconstruction with allograft.  Although tissue expanders required an additional operation, she preferred to use them.  Expanders maximize blood flow to the breast skin and nipple (because they are not fully expanded right after placement, they do not compress the tiny blood vessels in the skin), and they allow us to optimize the final implant size, location and appearance.

SUPPLEMENTS AND PREP: To prepare for and to recover from operations, patients can use a variety of supplements.  Angelina followed the regimen below, written onto a calendar:

To enhance wound healing (for each operation):

A) Vitamin C: 1000mg tablets; one tablet once daily for one week before and one week after surgery.

B) Multi-Vitamin: one tablet once daily for one week before and one week after surgery.

C) Zinc: 50 mg; one tablet once daily for one week before and one week after surgery.

To reduce the risk of infection (operations 2 and 3):

D) Bactroban ointment: Applied twice a day beginning 3 days prior to surgery x 7 days.

E) Hibiclens shower: Hibiclens soap applied to upper torso and abdomen – left on for 5 minutes, then rinsed. Applied once a day for 3 days prior to surgery.

F) Keflex: 250mg (antibiotic); one tablet 4x a day for 7 days, beginning with 2 doses the day of the operation.

To reduce postoperative nausea and vomiting (for each operation):

G) Emend: 40mg; one tablet by mouth the night before surgery

To reduce postoperative swelling and bruising (for each operation):

H) Arnica Forte (Arnica and Bromelain): two capsules daily x 7 days, beginning one day prior to surgery.

To help eliminate anesthesia from the system (for each operation):

I) Exchem: 10 drops in water or directly in the mouth twice daily, beginning the day before surgery and continuing for one week after surgery.

J) Lymphomyosot: 10 drops in water or directly in the mouth twice daily, beginning the day before surgery and continuing for one week after surgery.

To increase oxygen to the skin (operations 1 and 2):

K) Cutagenix: Applied to breast every 6 hours x 3 days. Skin care specialists use this topical cream after laser resurfacing to increase oxygen flow to the outer layers of skin. We decided in Angelina’s case to apply it to the mastectomy skin to give it an oxygen boost and to help ensure adequate blood flow to her skin postoperatively.

To minimize scarring (after operation 3):

L) BioCorneum: Rubbed into scars twice a day for 12 weeks – begin after the third operation once steri strips are removed.

Medications “as needed” for comfort:

Percocet: 1-2 tablets every 4-6 hours as needed for pain

Colace: 250mg twice a day

MiraLax: One tablespoon diluted in 8oz water once a day

Ativan: 1mg every 8 hours as needed for muscle spasm

Zofran: 8mg oral dissolving tablet placed on tongue every 6 hours as needed for nausea

LOCATION: Angelina chose to have her care, including her three operations, performed at the Pink Lotus Breast Center. Some people might think that a hospital is the only place to have a mastectomy.  However, outpatient surgery centers provide an attractive, peaceful alternative when coupled with attentive nursing care at recovery facilities. You can learn more about our comprehensive and integrative breast center by exploring this website.

STAGE 5. Recovering from the operations

On February 2, 2013, Angelina was in the operating room for the first operation, the nipple delay. Her partner was on hand to greet her as soon as she came around from the anesthetic, as he was during each of the operations.

After the operation, her skin was slightly bruised but soon returned to normal.  Two days after her procedure, great news arrived: the tissue behind both nipples came back completely normal.

On February 16 she had the main surgery, which can last up to eight hours.  The mastectomies went smoothly, with sentinel nodes identified but not removed.  After the mastectomies, I assisted plastic surgeon, Dr. Jay Orringer, as we performed the first stage breast reconstruction by placing tissue expanders with allograft.

To a large extent, I believe recovery reflects expectation. Angelina expected to feel well, to be active. On Monday, the pathology returned and I called Angelina to confirm our biggest hope: all of the breast tissue was benign. On day four after her mastectomies, I was pleased to find her not only in good spirits with bountiful energy, but with two walls in her house covered with freshly assembled storyboards for the next project she is directing. All the while she spoke, six drains dangled from her chest, three on each side, fastened to an elastic belt around her waist.

The next day she had her first injection of saline into the expanders, thus beginning the process that would gradually prepare the tissues for the final stage of her operations, reconstruction. Four of the six drains were removed.  Four days after that, on postoperative day nine, the last two drains were removed.  A second saline fill occurred on March 4. Over the next four weeks she was hard at work.

The final operation occurred on April 27, 2013, ten weeks after the mastectomies: reconstruction of the breasts with implant, which went extremely well, bringing an end to her surgical journey.

Conclusion

Many women unfortunately do not know that BRCA gene mutations exist and could affect them. Breast and ovarian cancers take lives every day – knowledge and action can help prevent the premature loss of those who love us, and whom we deeply love in return.

Like Angelina, I urge women who feel they might have reason to be at risk for a BRCA gene mutation – perhaps because of a strong family history of cancer – to seek medical advice and to take control of their futures.

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Lori Relf
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Lori Relf

I am a mother of 12 year old twin girls. This is my second fight with cancer. I am having a double mastectomy with reconstruction on Tuesday the 21st of May at Mass. General in Boston. I just wanted to say that reading Angelina’s story has given me a more positive attitude toward the surgery. I am very scared. My friends called me yesterday to tell me of Angelina’s story. Thank you for posting all of the great information.

Hilary Stookey
Guest
Hilary Stookey

You are already brave. It is courageous to admit that you are scared. Few would do that in an open comment. I am sure I’m not alone in reading this and rooting for you to pull through well, just like Angelina has done.

Joyce Hersh
Guest
Joyce Hersh

Good luck to you. May your lymph nodes be clear. It took me about 4 weeks to get back to work after a single mastectomy. Have your support network set up, get a bed wedge (pillows don’t really cut it), a shower stool, and a hand shower wand. Get your meds and schedule organized (with checklists). Do all the exercises the doctors give you, take care of your drains religiously (I put a how-to on WikiHow about this). This is a great time for your girls to pitch in, clean the house, make meals, etc. Trust me, just because you’re home, won’t make this a vacation. You’ll sleep ’till 7 or 8 because you’re tired, then you’ll get up, take your temperature, deal with your drains and take notes, take your meds, eat, do your exercises, wash up, and then it’s 11! And then you have to do your drains,… Read more »

Joyce Hersh
Guest
Joyce Hersh

Dear Dr. Funk: Please convey my full support to Ms. Jolie. I’m a breast cancer survivor myself, and mine was scary enough without the BRCA1 gene. The general public cannot really understand what it’s like to have to go through this kind of decision. One is truly staring death in the face, sizing up one’s odds, and making decisions on how to increase those odds. The only (remote) analogy I can think of is combat soldiers going out into the field. I had a single mastectomy (with reconstructive implant after). I did consider getting both, just to further drop my chances, but I decided that the additional surgery was too drastic (it really IS hard!), given that I didn’t have the gene. Imagine my distress two years later to find that several cousins now have breast cancer! One has died from it, and two sisters were diagnosed on the same… Read more »

Joi Morris
Guest

Thank you Dr. Funk for being such a great resource for our high risk community.

Glenda VR
Guest
Glenda VR

Thank you to Angelina Jolie for the brave decisions both to take control of her body and health, and also to share this journey. As a 10 year breast cancer survivor and Registered Nurse, I greatly respect the way in which this most sensitive and personal experience has been communicated. I believe this is an important milestone in raising awareness of BRCA testing, preventative and treatment options, and the empowerment of women.

Carolina Stella
Guest
Carolina Stella

Congratulations Angelina, an attitude very brave

William Avery Hudson
Guest

On top of everything else, Angelina Jolie turns out to be a first-class health communicator. Her NYT Op-Ed blew me away. A masterpiece of clear, concise, and empathetic patient education. I only wish the media reports were nearly as good as Angelina’s article. All I can do is promote her original article to all my lists.

LaurieMann
Guest

I also think “A Patient’s Journey” is very detailed and clear. One great thing about medical blogging has been the increased amount of clear writing about medical issues.

Mina
Guest
Mina

To Elizabeth Williams, so you are so obsessed with the past that you don’t realise that happened when she was a teen, and has NO baring on such a SENSIBLE DECISION now? Angelina was wild, but she did not have psychological problems. She was never diagnosed with anything, a short period of being wild (tame in Hollywood standards) does not equal ‘psychological problems’. It seems you are so full of hate and so judgmental that you are stuck in the past and cannot move on. Neither her wild phase or her short-lived ‘cutting’ mean DECADES LATER she isn’t stable and able to make a sound and rational decision. This is a woman that is so stable and of sound mind she is a SPECIAL ENVOY and is respected by Nelson Mandela. She has come a LONG WAY and is NOT the same person she was in her YOUTH. How about… Read more »

Charmaine Kok
Guest

Our experiences in the past do not necessarily define who we are as a person in the present or future. Having children completely changes your perspective of life and you do find yourself making decisions for their best interests and the best interest of your family as a whole. The loss of a mother is never something a child should have to face prematurely, I therefore commend Angelina for taking the necessary steps in ensuring a long life with her children, her family.

Kathleen M. Wickham
Guest

This is a much better option than waiting for BRCA to rear is ugly head leading to a much more invasive surgery, chemo and possible death. A very courageous move from a beautiful women that has done as much to combat this disease as the research to identify the gene has done. The surgery itself must have been difficult, but to go public given the way she has been treated for choices in her life is the courageous act Jolie has performed for millions of women and their families. I have watched her grow as a woman into a mother with a family she values. She has shown us as women we can misstep and still stand tall and move forward. She has shown us we are more than our looks, more than our breast, we are life to our children. A great act of commitment to mothers and women… Read more »

Taruna
Guest
Taruna

All the best. I suggest Angelina starts a charity to extend financial help to women from poor background in least developed countries to get the BRCA tests done.

Susan Feather
Guest
Susan Feather

Start with the USA where genetic testing is not covered by many ins companies and certainly unvisited women have zero access to genetic counseling much less testing or treatment.

Lisa LeBouthillier
Guest
Lisa LeBouthillier

Thank you for sharing your procedural information with everyone. I can only imagine that this is all very expensive sadly for far to many women, but none the less I am so pleased that Angelina shared her experience with others. She could have quietly done this and no one would have had to have known. I am so proud of her courage and her choice to be preemptive and choosing life.

Jennifer L.W. Fink
Guest
Jennifer L.W. Fink

As a nurse and a woman with a BRCA mutation, I believe that you’re doing women a disservice by only focusing on surgery. You write, “there are alternatives available,” but then proceed to list Stage 3 as “committing to an operation.” My concern is that some women will think that’s a normal and expected part of dealing with a breast cancer mutation.

bj
Guest
bj

I thank Angelina with all my heart for sharing with the world her BRCA1 experience. Angelina, you have adopted children which is why I am sharing this with you. I was adopted at one year old. At 61 I got uterus cancer. I had a hysterectomy followed by radiation and brachytherapy. At 62 I had Kidney cancer and a kidney removed. From Jerusalem one Sunday morning my husband answered the phone and handed it to me telling me a biological cousin I had never met or knew of was calling to speak to me. She told me that I should get tested for the BRCA1 gene. She emailed me a horrific family cancer history. I did get tested and was found positive. I began to actively and frequently monitor my breasts. I developed a tumor, had a double mastectomy and chemo. The tumor was triple negative. I have children and… Read more »

Anuj Kumar
Guest

Very useful information. Thank you for sharing
it. Thanks 99th.in

Jean Y
Guest
Jean Y

I believe this was a very smart move especially for a woman who has so much to live for. On behalf of women everywhere, “Thank you, Ms. Jolie, for sharing your story. By doing so you have saved more lives then you’ll ever know.”

Danish Perwez
Guest
Danish Perwez

its really really a great step in terms of preventive act from cancer in the medical history. its actually gonna help to many women in need out there.. Great work by the Doctor and perfect co-operation by the patient under treatment.

Belinda Renney
Guest
Belinda Renney

Amazing how Angelina Jolie can inspire so many. I am inspired all the way in South Africa and would love to be able to create programmes that can reach the more rural community in South Africa, that do not always have access to reliable information and testing.

Ariadne
Guest
Ariadne

While Ms. Jolie’s information is thorough and frank and I’m sure helpful to some, the problem I have with these procedures she is having is that the issue of LACK OF HEALTH INSURANCE by many women to have these proactive procedures is never addressed. Ms. Jolie is lucky, because she can afford to save her life, because she has MONEY!

siddharth
Guest
siddharth

this info is so crucial….such a caring act from Angelina jolie

Elyse Gunter
Guest
Elyse Gunter

Thank you to Angelina Jolie for being an example of how women sometimes need to take care of themselves by making unglamorous choices! I wish I had the benefit of her example when I was in my 30s!

Sonya Smith
Guest
Sonya Smith

dear Angilina, I NEED to say thank you!!! For YEARS I tried to get the BRCA test ( my maternal aunt tested positive, as did a cousin, and my grandmother died of breast and ovarian cancer) but my insurance would not cover the cost, and I am a disabled nurse. So for years I waited and prayed I could get the test before it was too late. Not long after you told your story, my doctor told me that “all of the sudden” my insurance was willing to cover the test!!! nearly nine years after I tried the first time to get the test….On Friday the 13th actually, I was told the test was positive. I underwent a radical hysterectomy/ oopherectomy in March 2014. On Nov. 12th 2014, I am scheduled to undergo a bilateral mastectomy. I am scared shitless, but I am SOOOOOOO relieved that I finally have the… Read more »

Shana Olson
Guest
Shana Olson

These genes are information every woman’s body holds (possesses, if you will-). In our inspired system of capitalism (that has been catapulting human rights revolutions the world over-) can hypercapitalists, can WE do no better than copyright information outpricing the very women, single moms, this information could most help and deeply affect. My dream is to see Angelina Jolie (my political hero who has done more with her wealth and fame to assist women globally than any feminist I know) follow Sheryl Crow, but provide a foundation where smart women researching and wishing to act on information their bodies hold, may receive grants to do so, based on need, until our government wakes up. That the mostly men running our world wish to demolish the souls of women rather than create value for society in the way they practice capitalism- lets down the entire world through a lack of leadership.… Read more »

Yvonne M Rangel
Guest
Yvonne M Rangel

I sit here trying to place my fingers to keyboard and I hesitate. I have hesitated since March 2015, when I was told :Positive for BRCA2. I was given a website (FORCE) to explore, but opened, closed, opened, closed and finally just closed. Was just too overwhelming or perhaps I was just darn tired, pissed off of the word “cancer”. You see, on Dec 24 2013 I was rushed to the ER, the CT showed a mass on both ovaries. And on Dec 30. 2013, it was confirmed; Ovarian Cancer Stage III. During the Hysterectomy surgery my ureter was nicked, resulting in a right Nephrostomy Tube placement. Followed by (2014) 6 months of Intraperitoneal Chemotherapy. August 2014, Nephrostomy Tube removal with a Stent Placement. During this chaos, a hairline Rt Fx hip and ear sx all caused by this darn, stupid chemo. So, I went on this crusade, I will… Read more »

Jacqueline Bastiaan
Guest
Jacqueline Bastiaan

I am 38 n I have had 8 weeks ago a double mastectom with instant reconstruction as i am a carrier of the BRCA2 Gene. I am from Holland and i am so flabbergasted to read here despite the fact families seems to be “infected” with brca n insurance does not cover tests. My mum had breastcancer (still lives) my grandma n aunts (2) died of it thus not a very good thing to see for my future. This operation and this desicion was best ever given to me! I knew i had a choice n i cd do something with this choice which was not always easy…. but where so many dont even know i did and eliminated almost 90% chance of breast cancer! I am not given eternal live but most def a longer life n am very gratefull for that!!

SAKET KUMAR
Guest
SAKET KUMAR

I really appreciate with such hard decision and sharing it with the world for the benefit of other women….. Hats Off Angelina…..

Cricket
Guest
Cricket

I am currently in week 8 of recovery/reconstruction. In addition to having a mutated brca 1 gene I had 11 anomalies in my right breast and six in my left. Five years ago I had two rare tumors removed from my left breast and I had very dense breasts. This choice was hard. Emotionally and financially. I had to have a second surgery six weeks out from the first because of severe pain. During this surgery it was found that they had sewed through a nerve when sewing my tissue expander in. I am please and blessed to say I am recovering well. I lost my nipples abs had my sentinel nodes removed. I would make this choice again. I know this if this did not save my life, it certainly saved me from battling cancer. My only regret the preventative/cancer insurance did not cover this. Ladies take a stand.… Read more »

Marie Curie
Guest
Marie Curie

Gracias a Angelina por compartir tu experiencia!

Justine
Guest
Justine

I sincerely with to thank you – Mrs Angelina Jolie Pitt. I always knew I had a problem, given my family history, but your coming out gave me the strength to go and test myself. I am BRCA 1. It was really terrifying to have this confirmed, but after the first few weeks of fear and misery, I now own that I have life, health and now knowledge, and because of this, choice and direction. Many people are poo pooing your decision to come out and tell your story, and cynically using your truth and sharing as a platform for blaming you for your supposed publicity. How naive. When will people learn that truth and sharing comes with such love and care – and bravery, especially if one is famous, with ones every move of interest to the world in general. I hope that in your dark moments, and your… Read more »

Pat Phillips
Guest
Pat Phillips

I would like to know when Angelina Jolie knew she carried the BRCA1 gene. Was it prior to getting
pregnant with any of her children? If so, she knowingly took the chance of passing this gene on to

her children. I am a breast cancer survivor and find it very disturbing to see what is NOT being talked about relative to breast cancer and Angelina Jolie’s op-ed piece.

Trialia
Guest
Trialia

She would have passed the gene on whether or not she had been tested and found it. We’re not as far advanced as to be able to delete and replace genes in a human that easily. Yet.

RJ Cote Robbins
Guest
RJ Cote Robbins

I am a two-time breast cancer contender I call myself…27 years from the first surgery, and I credit my longevity to early detection. I also support the proactive surgeries. I find the disclosure by Ms. Jolie at the level of Betty Ford and other brave women who dare to address the taboos in our society. I wish her health and brava!

Isabela
Guest
Isabela

I am 24 and at age 23 I was diagnosed with breast cancer.I still have three months of fighting and then I will have a double mastectomy.What Angelina did and the fact that let the world know about it is great.It encourages women :). If I had known that I could get breast cancer at 23, I would have done BRCA testing and removed my D cup breasts in an instant.Be proactive, it is all worth it! 🙂

Usha
Guest
Usha

At the age of 26 when my Dr told me that I have breast cancer , I was shatter like everyone else I came to the US 202 for chemo fellow by radiation , twelve years later I felt a lymph on my opposite breast ,my dr recommend for me to do the genetic test and there I found out that I have the brca1 . I had mastectomies and now I’m on chemo the chemo treatment is so hard on me I get so sick but I’m hanging in there I pray for all of us out there of course I myself haven been able to go into that acceptance mode yet .

billy
Guest
billy

her new breasts are a bit lopsided.

Mike F. Janicek MD
Guest
Mike F. Janicek MD

[Ovarian Cancer] “Prevention does not yet exist.”

NOT TRUE!! Removing tubes/ovaries, and possibly just the Fallopian Tubes, is as effective a risk reduction intervention as breast removal. SCREENING is ineffective, as ovarian cancer can sneak up with little warning in a matter of months….The ultrasounds and CA-125 you describe simply announce the ARRIVAL of a deadly disease, with no studies showing that these “screening” strategies help catch ovarian cancer at early stages.
ALSO, removing ovaries can cut the risk of Breast Cancer in HALF, even in BRCA-mutated patients, so many of my patients do the ovarian risk reduction surgery first, then consider breast surgery. If you don’t believe that Ovarian Cancer can’t strike while deliberating or delaying, I’ll hook you up with some of my patients who are fighting for their lives with ovarian cancer and will give you a different perspective.

Colleen Thompson
Guest

I am 34 and found a lump in my breast in Nov. 2012. The doctors saw nothing on the mammograms, ultrasounds and even an MRI, with contrast. All of the doctors insisted it was nothing and told me to come back in a few months if the lump grew. I had one nurse practitioner in my corner who fought to get a biopsy scheduled. I had invasive cancer throughout one of my breasts and my surgeon told me that most likely I’ve had it for 7-10 years. None of the doctors even knew how many tumors there were because the tissue in my breasts were so dense. I had a lymph node test and found out that the cancer was just starting to spread. I had a bilateral mastectomy in January and I have great insurance through my husband’s job and it did not cover one penny of the BRACA… Read more »

Monika
Guest
Monika

EVERYBODY LISTEN CAREFULLY ! If you eat a PLANT BASED DIET you will NEVER HAVE TO WORRY ABOUT CANCER! On a plant based diet there is no chance for any disease !
PLEASE READ China Study and Whole books! You can save your own Life, your own Breasts, your own Prostate, your own Heart, your own Bones !!!
Don’t let the “billion dollar cancer business” make you believe otherwise!
Very sad for Angelina! There is no bad DNA, only bad diet/eating habit history! If you eat the same animal protein based diet like your family has of course you will likely have the same condition…
Switch your diet to PLANT BASED EATING !!! IT WILL BE THE EASIEST AND QUICKEST HEALING PROCESS YOU CAN EVER IMAGINE ! __ SAVE YOURSELF !

maria c.
Guest
maria c.

I applaud Angelina Jolie’s wise decision. As an RN and a 10 year breast cancer survivor, I wish Angelina the best and thank her for sharing this very important information in a clear, concise way. One thing that concerns me is that there has been no mention of the enormous price tag of this procedure, putting it out of reach of most American women. The BRCA genetic test cost about $3000 and is not covered by most insurance companies. Even if the test was positive, I believe a woman would have a huge battle on her hands trying to convince an insurance company to pay for a bilateral mastectomy, and as for reconstruction, in the absence of cancer, well, forget it. All of the surgery Angelina had, and will have, is elective, paid for by no insurance company I know of. We are easily closing in on $100,000.00, I am… Read more »

Shana Olson
Guest
Shana Olson

What a great day of justice in the Supreme Court recently. What great hope for our sisterhood in ridding ourselves of this disease- and what optimism it offers our country in humanitarian effort.

Laura Robbins Callen
Guest
Laura Robbins Callen

I’m able to take the BRACA testing due to my strong family history of ovarian cancer, however, as Ms. Jolie states the price of the test is an obstacle for the average person. Insurance won’t pay for it (shock) so I won’t be having a preventative test to perhaps spare my insurance company (and myself) the expense and pain of cancer treatments. It makes no sense! If I were able to do it, I’d make the same choice as she, and have a total hysterectomy as well. I assume that’s next on her agenda after she’s well? Best wishes to her, and prayers for her full recovery.

BREEZE PACIFIC
Guest
BREEZE PACIFIC

The doctor’s team experience is a certain breakthrough for Americans’ troubled healthcare, especially the determination of “which lymph nodes in her arms were
draining fluid from the breasts”. I was wondering for all non-star yet future BC-victims how their hands are different, because I am survivor of my late wife, heavily suffering exactly from that “in hand lymphedema” … and toothache 🙂 – our crazy doctors did not take latter seriously, as well my judges are not able to understand people without any pocket attorney. Go ahead America – we will win!

Jenny Pelley
Guest

B – be brave
R – research
E – educate
A – accept
S – strength
T – tolerance

C – compassion
A – apathy
N – new normal
C – changes
E – emotion
R – recovery

Johanna
Guest
Johanna

I would like to thank Ms Angelina Jolie for her courage to share her story about BRCA-1 with the world. There’s a lot of judgement due to ignorance and now there’s attention in the media for this subject. I’m from the Netherlands and i’m 34 years old. About 5 years ago i have had a double mastectomy because of BRCA-1. I wish her all the best for her further recovery and strengh by making a decision about the ovaries. For me, at this moment, i have decided to do the check ups for the next few years before doing the surgery for the ovaries. Thank you Ms Angelina Jolie for telling your story, it really moved me.

Colleen
Guest
Colleen

Last year I was diagnosed with DCIS, and opted for bi lateral mastectomy. My genetic testing came back with no markers. I never even felt a lump, but 2 showed up on my mammogram. I never felt sick, I went through a 10 month police academy with cancer and never had a clue. I was just entering a career in law enforcement , so not a topic to discuss with my male co-workers. When people hear cancer, they react like you have been handed a death sentence. That doesn’t have to be the case. Six weeks post-op I started “bootcamp” type police training, I don’t recommend this, it is mentally and physically demanding , I even had one expander fail. I had to wait for 3 months with one boob until I could have my final implants placed. I had my final implants placed in August and I had 3d… Read more »

HalleG
Guest
HalleG

DX’d at 36 with IBC. I know this is an older post but I was BRACA 1 2 Neg. I am in the process of getting more genetic testing that was not available a few years ago. PTEN & lynch Syndrome are two other genetic tests that can be take if you have a family history of breast cancer or develop it early such as myself. The more you ask for in regards to tests, usually the more care you get. Don’t be afraid to speak up for yourself!

BORIS K'ZORIN
Guest

In the time of Breast Cancer Businesses /cutterpiller(s)/ activation the state (Employment Development
Department) still does nothing on its part, as to provide the deserved relief for and support BC-victims’ choice to be on track in real life … as much as possible.

Rhea Cote Robbins
Guest

I am a two-time breast cancer contender I call myself…27 years from the first surgery, and I credit my longevity to early detection. I also support the proactive surgeries. I find the disclosure by Ms. Jolie at the level of Betty Ford and other brave women who dare to address the taboos in our society. I wish her health and brava!

Candice
Guest
Candice

Don’t know where my original comment disappeared to but for all you critics, you have NO IDEA how it feels when every immediate family member female around you is faced with this. This seems to be the only option in prevention now. And for the organic fruit cake guy, I do all that, and there are still no guarantees. There is too much crap in the environment already to affect a change especially when you are predisposed.

Jennie Thibodeau
Guest

I was diagnosed on 3/11/13 with a 4cm tumor in my right breast. The cancer has also spread to my lymph nodes. I did everything right – baseline mammogram at age 35, yearly mammograms starting at age 40, regular self exams. Because of my cystic breasts, my mammograms were switched to every six months, along with ultrasounds. With all this monitoring, I am the one who found my tumor. The mammo did not catch it, even with me pointing right to the spot and saying that something felt ‘different’. So, now I’m 43yrs old – bald, sick from chemo and counting down the days until I can have my double mastectomy. I cannot wait for these breasts to be gone. They were trying to kill me. First, though, because of my lymph node involvement, my doctors are treating me with neoadjuvant chemotherapy. That’s fancy talk for chemo before surgery. I’ve… Read more »

Tracy Strimling
Guest

Wishing you only the best Jennie. I had a similar experience, finding a lump 4 months before I was due for my yearly screening. A mammogram discovered an additional lump and I had lymph node involvement as well. I had my right breast removed prophylacticly (due to family history and aggressiveness of cancer) but saved the nipple. In your instance it may be unwarranted but it might be worth a discussion with your surgeon.

Best of luck to you as you navigate your road to good health.

Jennie Thibodeau
Guest

I was diagnosed on March 11th of this year with a 4cm tumor in my right breast. Cancer was also found in my lymph nodes. I did all of the ‘right’ things – a baseline mammo at age 35, regular self exams for years, yearly mammon that evolved to twice a year mammograms and ultrasounds…and I still got breast cancer. And my tumor, all 4cm of it, did not even show up on the mammogram. I found it myself, but not before it had spread to my lymph nodes. Now, I’m in a hellacious fight to save my life so I can watch my 7yr old twins grow up. I am sitting here, 43 yrs old, bald as a baby, sick from chemo and anxiously awaiting my surgery to have my breasts removed. I cannot wait. My breasts have betrayed me (yes, that is what it feels like, people), and… Read more »

AmericanFirst
Guest

My 2 sisters and I did not test positive for either BRAC 1 or 2, yet my two sisters at relatively the same age (51)were diagnosed with Estrogen Pos. Br. Cancer. The year I turned 51, I was diagnosed with LCIS. A diagnosis of LCIS is also considered high risk. My older sister lost her battle, my middle sister opted for a bilateral mastectomy. I am in the middle of the process of the skin saving mastectomy.

tina cunningham
Guest
tina cunningham

I had learned of genetic testing development from Kolman Cures organization. I have lost about 4 friends from breast cancer. I am a Registered Nurse and am so happy to have seen such revolutionary women’s care as I recall when I first became a RN, the only conservative to the radical mastectomy to modified mastectomy and many of these women were very fortunate to live as they often had metastasis to many areas before they knew they had a problem. You mentioned in your article that the US medical treatment is far advanced and many women “in middle, lower income in other countries” do not have access. I am actually a RN that lost work due to government cuts and not employed at this time. The healthcare industry is intentionally not hiring new employees and especially RNs with experience because of more pay just to make profit before the Affordable… Read more »

Carina Pinkston Piccinini
Guest

FYI regarding your comment that breast implants for reconstructive surgery is considered elective surgery. It is state law in Illinois that insurers provide coverage for reconstruction after mastectomy. I am unsure if that applies to prophylactic mastectomy and I also don’t know if it is a requirement in all states. As my plastic surgeon stated, there is no time restriction, and if I need a revision 20 years from now, insurance will cover it, given the current law in effect. I have heard anecdotal horror stories about HMOs, but mine has covered everything, including my BRCAnalysis and my prophylactic TVH-BSO. I’m not trying to be argumentative, but I just want to encourage women to do their due diligence when shopping for coverage, to understand what they are medically entitled to by law, and to be sure to follow all the requirements of the insurers for care.

Carina Pinkston Piccinini
Guest

I really wish people would respect decisions that women make with regards to breast cancer. It is a very personal decision that is never made lightly. It is very difficult for me to understand why some insist on saying she made the wrong decision. As someone with a BRCA2 mutation who was diagnosed with breast cancer last year at age 41, I can tell you she potentially avoided that awful waiting game from a sentinel node biopsy once diagnosed with breast cancer, additional surgeries, and chemotherapy by acting on her risk profile. I am scheduled to have my ovaries and uterus removed next week, although I don’t have cancer on those organs. I don’t really care what you think of me, but other women who read your criticisms of this actress and are faced with the same agonizing decision-making process may indeed be swayed by your self-righteous commentary. Respect the… Read more »

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