Mastectomy Prevention – Angelina’s Inspiring Story

What is breast cancer?

Breast cancer is a serious disease with nearly 700 new cases being diagnosed every day according to the American Cancer Society.

Cancer is a disease that can occur anywhere in the body. All of the cells in the body replicate, but healthy cells know when to stop. Cancerous cells don’t stop growing. They keep growing out of control, and can form tumors. “Benign” tumors are cell growths that are contained and don’t spread into surrounding tissues or other areas of the body. “Malignant” tumors are tumors that grow into surrounding tissues and can spread or “metastasize” into other areas of the body, most commonly through the lymphatic system or the blood.

Breast cancer occurs when cancer cells or a tumor are found the breast tissue. Breast cancer is most commonly found in the milk ducts of the breast (ducts), or in the glands that produce breast milk (lobules).

Breast cancer can affect men or women, but it is most common in women.

Breast Cancer Causes and Risk Factors

Genetics (family history), lifestyle, and medical history can all play a part in an individual’s risk of developing breast cancer.

A risk factor is anything that affects the likelihood of developing a certain disease or condition, but it’s not a guarantee. Some people who develop breast cancer have no apparent risk factors. Some people who have many risk factors will never develop cancer. For these reasons, its important to understand your personal risk factors and take proactive steps to catch any unusual changes early on.

Risk factors that may increase the likelihood of a person developing breast cancer include:
● Aging (risk increases after age 55)
● Certain conditions of the breasts like hyperplasia
● Drinking alcohol (2 or more drinks per day)
● Family history of breast cancer in immediate biological relatives
● Genetic markers BRCA1 and BRCA2
● Hormone therapy
● Long-term hormonal birth control
● Nonparous women (women who have never been pregnant)
● Overweight and obesity
● Physical inactivity
● Smoking cigarettes

Treatments

Breast cancer treatments vary widely based upon the location, size, stage, and presence and type of tumor. Treatment may include major or minor surgery, therapies like radiation, or medications like chemotherapy.

Early stage breast cancer is most commonly treated with a combination of surgery, radiation therapy, and drug therapy to remove and prevent the progression of cancerous cells. Advanced stage breast cancer typically include drug therapy to treat the breast tissue and surrounding tissues which may also be affected by the cancerous cells.

Treatment is different for every breast cancer patient. It’s important to have a good relationship with an oncologist specialized in breast cancers, and to thoroughly discuss and review all available options.

Mastectomy, the removal of the breast, is a more advanced treatment option for aggressive cancers. Unlike surgeries like lumpectomy which only remove part of the breast tissue, mastectomy removes all of the underlying breast tissue. This can be done on one or both breasts to avoid a recurrence of the cancer. Some patients follow a mastectomy with breast reconstruction surgery (implants), while some patients opt out of reconstructive surgery. Because it’s not possible to completely remove all breast tissue, there is still some risk of recurrence even after a mastectomy, but the likelihood is much lower.

Prevention & Being Proactive

Women and men can take steps decrease their risk of breast cancer. Knowing the signs of breast cancer and understanding your own breast health is an important step in prevention and early detection.

Do-it-yourself prevention steps include:
● Avoiding known risk factors like smoking and excessive drinking
● Looking at your breasts regularly for any changes or irregularities
● Maintaining a healthy weight
● Self breast examinations
● Staying physically active

When doing self exams at home, feel for any unusual lumps. Many women have naturally dense breasts, so performing regular self-exams every couple of weeks will help you detect changes that aren’t normal for you. When doing a visual examination at home, look for any unusual swelling, dimpling in the skin, changes in the nipples, or unusual discharge. If you feel any pain, irritation, or heat in the breast these could also be signs of an underlying issue and you should seek immediate medical attention.

Annual visits with the doctor are also important steps in cancer prevention and early detection. Prevention steps with your doctor include:
● Annual examinations
● Genetic testing
● Mammograms
● Ultrasounds

If you have risk factors or early indicators for breast cancer, your doctor may have you perform diagnostic tests more frequently to monitor your health.

Prophylactic mastectomy is another proactive treatment option for women with a very high risk of developing breast cancer. Prophylactic mastectomy is voluntary surgery whereby a woman has one or both breasts removed. This procedure can reduce the risk of developing breast cancer by as much as 90%. A woman may be a candidate for prophylactic mastectomy if she has exceptionally high risk factors such as the BRCA1 or BRCA2 gene mutation.

One high-profile example of this is actress Angelina Jolie who in 2013 elected to have a prophylactic double mastectomy. Jolie’s mother died of ovarian cancer at age 56. Jolie also found that she had the BRCA1 gene mutation. After being told by her doctors that her family history and genetic condition put her at an 87% risk of developing breast cancer, Jolie decided to be aggressively proactive with her treatment. She wrote a compelling op-ed for the New York Times about her decision to undergo the surgery to improve the odds of being around for her children and having a better quality of life by taking every precaution to minimize her risk. Women considering a prophylactic mastectomy should speak with their doctors about risk factors and how the procedure may help reduce the chances of developing cancer.

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