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Angelina’s Choice

June 5, 2013 By:
Elyse Glickman
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Entertainment and  info-tainment television often thrive on the questionable personal decisions of celebrities, as well as an attitude that they live by another set of rules because of their fame.

However, when a celebrity gains notoriety for being like regular people in a meaningful way, this is not just news, but something entirely “newsworthy.” Last month, Angelina Jolie — no stranger to headlines documenting her celebrity lifestyle — made an announcement about her decision to undergo a bilateral mastectomy that made her accessible and relatable to women from different walks of life.

“I have read a lot of the comments regarding Angelina Jo­lie’s medical decision, including those from Monica Morrow and Susan Love, two well-known breast surgeons,” affirms Dr. Nancy Elliot, a surgeon, breast cancer survivor and founder of the Montclair (N.J.) Breast Center.

“This is only good news for women, as it raises awareness and starts conversations. What is so very special is that it tells women that double mastectomy is not something to be ashamed of.”

Jolie, she adds, “will still be famously beautiful and have a gorgeous figure now, even after bilateral mastectomy. This is empowering for women.”

While Elliot notes that today’s medical surveillance technology is very good and can pick up early breast cancers that are curable, other small cancers are aggressive and may require chemotherapy for treatment. She also hopes women who decide to keep their breasts understand the small but definite increase in risk of death from breast cancer when they choose surveillance over a double mastectomy.

Although Jolie is not Jewish, her decision to go public with her course of action because of her genetics resonates with Jewish women because of their potential breast cancer risk, according to Melanie Corbman, a certified genetic counselor at Cancer Treatment Centers of America, which has its headquarters in Philadelphia.

Corbman points out that people of Ashkenazi descent (ancestry from Eastern Europe) have a 1/40 chance of carrying the breast cancer-related BRCA mutation compared with the average population risk of 1/500-1/800.

Jolie’s decision, she notes, “will have a positive impact in terms of reducing her risk to get breast cancer to 5 percent, lower than the average population risk of 12 percent.

“Her going public, meanwhile, will have a very positive impact in terms of raising aware­ness of hereditary breast and ovarian cancer, genetic testing and ways to protect yourself against getting cancer if you know you have a hereditary risk.”

Corbman notes that it is always prudent for Jewish women with a family breast cancer history to be screened regularly. Starting at age 25, breast self-exams, biannual clinical breast exams and annual mammograms and breast MRIs are recommended.

She adds that women with BRCA mutations have up to an 85 percent risk of being diagnosed with breast cancer. If diagnosed once, they have up to a 65 percent risk of getting diagnosed with a second breast cancer.

Even with Jolie’s decision to undergo the procedure to ensure she could live longer to “be there” for her children, several physicians and health experts, such as Orlando, Fla.-based Terrl L. Folker of Nouveau Contour Permanent Makeup, point out each woman needs to weigh the pros and cons in terms of finances, appearance, recovery time and lifestyle.

“There is a huge expense involved to do it properly with the lengthy reconstruction that may or may not be covered by insurance,” Folker says. Women also have to face the fact that “the recovery time is long, and extended care for children, husband, and home will need to be considered. Time away from work will be a factor.”

Questions about reconstruction and medical tattooing should be asked so those procedures and costs can be evaluated in advance, he adds.

According to Dr. Steven Davis, a Cherry Hill, N.J.-based plastic surgeon, today’s cosmetic procedures are much more advanced and less invasive, with more refined surgical techniques than they used to be. One option his prac­tice offers is a recently FDA-approved cohesive anatomically shaped silicone breast implant that yields a truly natural look.

“Angelina Jolie was likely the most ideal candidate for this type of procedure,” says Davis, because “she was in overall good health.”

Retired Beverly Hills plastic surgeon Dr. Alvin Reiter, who authored the moving autobiography Even Doctors Cry, praises Jolie for having performed her most difficult role to date. He agrees that undergoing a double mastectomy and sharing it with the world takes courage and foresight.

However, he says he also wanted to take his and his wife’s story public in the book to reach out to women dealing with crises similar to Jolie’s, as everybody’s situation is different. He points out a lot of questions need to be asked, especially when it comes to the doctors with whom a woman will be working.

In the case of Reiter’s wife, Karen, she was diagnosed with breast cancer and given over a 95 percent chance of a cure following her double mastectomy. Unfortunately, during the operation, the surgeon reportedly failed to remove every last bit of breast tissue.

“Over the years the cancer spread, and Karen died at the age of 55,” Reiter says. “While Ms. Jolie’s message is one of great inspiration to women worldwide, it must be noted that for many women, undergoing a double mastectomy may not be the solution.

“Vigilant health screenings, constant monitoring of health and diet, and scrupulous questioning of the medical establishment is necessary.”

He adds: “The medical system let my wife down.

“As a doctor myself, that has been hard to live with,” says the physician, whose book is “a means to help countless women worldwide gain a better understanding on how to take their life into their own hands.”

Marcy Brenner, a songwriter/musician from North Carolina whose story was the subject of the documentary Dead Girl Walking, believes Jolie is unquestionably a hero for going public with such a life-changing decision. “Sharing our stories is the only way we can help each other,” Brenner states. “I am an advanced breast cancer survivor who used genetic testing to make informed medical decisions. Ms. Jolie will help so many others benefit from this modern technology.

“When I saw my post-surgery chest, I felt the words, ‘It’s OK!’ rise to my lips. As Ms. Jolie said, ‘I’m still a woman.’ ”
 

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