This morning, Angelina Jolie revealed that she underwent a preventative double mastectomy because she had a faulty BRCA1 gene, which put her at an 87 percent risk for developingÃ‚Â breast cancerÃ‚Â and a 50 percent risk for developingÃ‚Â ovarian cancer.
"Angelina Jolie is one of the most famous superstars in the world and is also notoriously private," says Lindsay Avner, the founder and CEO of Bright Pink, a national nonprofit that focuses on the prevention and early detection of breast and ovarian cancers, while supporting high-risk individuals. "It says a lot about this issue that sheÃ¢â‚¬â„¢s willing to bring it to the forefront and encourage women to know their risk and their family history."
The news hits close to home for Avner, and not just because she's a breast and ovarian cancer awareness advocateÃ¢â‚¬”she underwent the same procedure to slash her breast cancer risk almost seven years ago, at the age of 23. At the time, she was the youngest person in the country to make the tough decision to remove two healthy breasts.
Avner's grandmother and great grandmother both died from breast cancer, and her mother had her own double mastectomy after being diagnosed with the disease. When Avner found out that she had a BRCA gene mutation at the age of 22, she started going to the doctor for regular clinical exams, mammograms, and MRIs.
"It really felt as if I was waiting to get cancer rather than doing anything to prevent it," she says. "It was like I was just a ticking time bomb and it was only a time before cancer was coming for me."
So in the spring of 2006, when she was getting ready for a night out with her college friends and realized that many of them had undergone breast surgeries for cosmetic reasons, she had an epiphany.
"I realized, 'WaitÃ¢â‚¬”for a couple of scars I have an opportunity to not worry about this, to not have migraine headaches out of stress, to not feel this tremendous pressure to hurry up and get married tomorrow so I can have kids before cancer strikes,'" she says.
Just a few months later, in August 2006, she had both of her breasts removed atÃ‚Â Memorial Sloan-Kettering Cancer Center in New York CityÃ¢â‚¬”with the same doctor who had performed Avner's mother's double mastectomy.
"ItÃ¢â‚¬â„¢s so much more emotionally exhausting than it is about the physical pain," she says (although, for the record, Avner says the initial procedure was pretty painful). "ItÃ¢â‚¬â„¢s about reconciling with parting with your breasts and the fears that everyone has: Will this change who I am? Will this change how I see myself?"
Just as with Jolie, Avner had a nipple-sparing mastectomy during which doctors placed tissue expanders in her chest to preserve her skin's elasticity. Then, four months later, she had implants put in.
"This is a very personal decision that is not right for everyone, nor should everyone go out and get genetic testing," says Avner. "ItÃ¢â‚¬â„¢s based on having a family history and putting a lot of thought into it and discussing the process with your doctor."
So while you don't necessarily need to go out and have genetic testing done this second, you can take other steps to evaluate your likelihood of developing breast and ovarian cancerÃ¢â‚¬”as well as what you can do about it. It's important to note, for instance, that while a double mastectomy might be the right choice for some women, like Avner and Angelina Jolie, other women will have different needs, and should be aware of the differentÃ‚Â treatment optionsÃ‚Â andÃ‚Â preventative actions they might want to pursue.
Step one, regardless: Get informed.Ã‚Â Bright Pink's Assess Your Risk tool will help you see how your family history and various lifestyle factorsÃ¢â‚¬”like whether you smoke and how often you work outÃ¢â‚¬”affect your odds of getting breast or ovarian cancer. Once you're finished taking the interactive quiz, the site generates a personalized PDF you can print out and take to your doctor to start a conversation about your cancer risk.
"Knowledge is wonderful and awareness is important, but itÃ¢â‚¬â„¢s action that saves lives," says Avner. "Knowing this information only takes you halfway thereÃ¢â‚¬”itÃ¢â‚¬â„¢s about, what are you going to do with it? I think this is a really powerful opportunity, a moment we have to take all this awareness thatÃ¢â‚¬â„¢s being generated and empower women to really take action to develop a proactive approach to their health."