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And Still More about Angelina Jolie and her Decision

Posted 5/16/2013

Posted in

  I am aware that one way of looking at this is that I can't let it go or know when enough is enough or am obsessed with the news about Angelina Jolie's decision. I suppose that all three views are a little true, and I am sometimes (my husband might say often) guilty of not knowing when enough is enough. However, in my defense in this instance, this news has continued to dominate my time, and I am hearing from so many women who are reacting strongly. At the end of a group for women post treatment yesterday, this came up. One woman, who has had bilateral mastectomies after a high risk breast cancer, began to talk passionately about her own situation, and it was clear that the news had stirred up many intense feelings that were overwhelming.

  So this news is both about her decision and whatever it means to us or whatever it stirs up inside us. If you are seeking more solid information about hereditary breast and ovarian cancer, check out the FORCE website at

  I am sharing today a terrific article from The New York Times by Peggy Orenstein. It is a wonderful mixture of facts and truths and feelings and reactions. Here is a quote and a link to read more:

My concern going forward is that people remember that Jolie is not a woman of average risk. She is not even a woman of somewhat elevated risk. She is, sadly, a woman at very high risk of cancer, one with a genetic predisposition and a family history of deadly disease. Only .1 percent to .6 percent of the general population have the mutation Jolie carries (though everyone probably has mutations that predispose them to something). The rate among Ashkenazi Jews is about 1 percent. That means that having a mom who had breast cancer, for instance, especially if she was older when given her diagnosis, especially if her tumor was low-grade, is not an indication of a mutation in your family nor necessarily a reason to test — or to panic.

We have to be careful not to conflate Jolie’s situation and choices with those of an average woman or even with those of a woman who receives a diagnosis of low-grade breast cancer or ductal carcinoma in situ (D.C.I.S.) — a kind of “precancer” in which abnormal cells are found in the milk-producing ducts. Preventive double mastectomies among women in that latter group have shot up by 188 percent since the late-1990s. The steepness of the rise suggests those operations were driven less by medical advice than by women’s exaggerated sense of risk of getting a new cancer in the other breast. According to one study, such women believed that risk to be more than 30 percent over 10 years when it was actually closer to 5 percent.


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