Speechless. I don't even know what to think about the choice and odds.

That's an incredibly hard decision to have to make. Gutsy lady!

While I think such a decision is both personal & difficult, and I think it's great she thinks about such things and takes control of her life, I feel compelled to note that a low risk of something doesn't mean it won't happen.

For instance, the risk of a man getting breast cancer is VERY low. The American Cancer Society estimated there would be about 1,900 cases in the year 2010 - when the US Census pegged the male population at about 152 MILLION. For perspective, if it had been an even 2k cases for just 1 million men, that would be a 0.2% risk, so for 100 million, it'd be 0.002%. But, it clearly impacts the men who get it.

I have trouble seeing how it could be a hard decision. 87% chance I'm getting it? Of course the boobs are going. I'm pretty sure I would even at 20 or 30%.
Good for her for being upfront about it. I imagine that was hard, being in such a looks-driven sexual industry.

My aunt, whom I'm named after, died of ovarian cancer. Once she was diagnosed it took only 2 months for her to die. From my understanding in the end she got skin metastases on large parts of her body.

I can imagine lots of women who can afford to be tested just dont want to "know".

The type of cancer I find fascinating is transmissible cancer, from one animal to another. I think there was one case of patient to surgeon cancer.

It's great we are finding out how genes/cancer works.

"Courageous Revelation"? Is the choice to get a double mastectomy somehow seen as shameful and likely to get one ostracized from polite society? Hell, coming out as *gay* isn't even courageous anymore, it's become positively *trendy*, so how is admitting to preventive surgery "courageous"?

I'm with you, momof4. I had BRCA testing because I'm in a high-risk group -- Ashkenazi Jewish ancestry (the pale Jews of Northern Europe). If I had an 87 percent chance, as you put it, "of course the boobs are going."

It's obviously a scary and upsetting thing, and I'm glad for her that she was able to keep this a secret while it was going on.

And yes, Ppen about learning more about this, but I sure wish we could learn faster!

I suggest that this is a better reason to put flags at half-staff than somebody setting off bombs.

I admit I don't know a lot about this, but why couldn't someone with her wealth just get screened monthly and intervene only if necessary?

"Is the choice to get a double mastectomy somehow seen as shameful and likely to get one ostracized from polite society?"

No, but it's likely to affect her status as a sex symbol, even among people who empathize and agree with her decision. So I do think that coming out was brave.

Insufficient Poison, screenings carry their own risks---cost isn't the only reason that women get them as infrequently as we do. Plus cancer can grow very quickly. My mother has breast cancer, and it was astounding how a tiny (2cm?) spot detected on the mammogram grew huge in the few weeks between the mammogram and the biopsy/mastectomy. If she waited til the cancer developed, she'd still likely need chemo or radiation after surgery.

I say good for Jolie.

And yet she kept her ovaries even though they are almost as likely to kill her

Luj, reading between the lines it sounds like she'll make a decision/do something re: her ovaries later.

Who says she's keeping the ovaries forever? She said she did the mastectomy "first" not "instead". And hysterectomy/removal of ovaries (I forget the name for when they only take the ovaries) is a much more complicated surgery which will have a bigger effect on her day to day life and health. Also 50% is not "nearly" 87%, and you'd have to consider how much risk the surgery removes---I think the ovarian surgery doesn't actually reduce the risk as dramatically as the mastectomy.

Jason - you took the words right out of my mouth

Also, total hysterectomies screw with your hormones. Menopause comes quick enough, thanks.

" so how is admitting to preventive surgery "courageous"?"

Because even the most minor of surgeries carries an inherent risk. Even the gas, in extreme cases, can kill you.

That's why they made waivers.

"Jason - you took the words right out of my mouth"

Her success is largely based on her being a gorgeous, sexy woman with a perfect body. Publicly admitting that her breasts have been /removed/ is brave.

Jenny, appreciate the explanation.

Admitting to having your breasts lopped off when Hollywood puts sex appeal front and center - yeah, that's pretty courageous for a Hollywood actress. Every time she goes out in a tight sweater someone's going to write an article about her tits from now on.

Hopefully if she gets the message out that "If this has to be done your life still continues on", someone in despair over a mastectomy might draw some hope from her openness.

I'm not a fan of her movies, though. At all.

Actually Jenny removing the overies would drop her risk to zero.

And 5 is infinitely larger than zero

She didn't really get them "lopped off"--I'd guess that the breast tissue was replaced with whatever they use now, but the skin and nipples were left intact, which is pretty cool. I think she's brave because (a) she's a movie star with sex appeal, and (b) she didn't have to tell anyone anything.

Um, seeing as she can more than afford reconstructive surgery, (implants) I highly doubt this is going to effect her in the "looks" dept. In fact, I imagine that she'll get more work than ever now from the publicity this "decision" will bring her.

Sorry but I have a hard time allowing myself to believe she is anything but a publicity hound at this point. I think making a decision like that is brave and I commend her for her ability to put her health over her vanity but frankly, I wonder why she said anything at all. She managed to keep it private this whole time then suddenly, she's making statements about it. Why? She could have easily just gotten the reconstructive surgery and no one would have been the wiser.
I'm skeptical.

Removing ovaries puts you into immediate menopause. HRT helps, but is not nearly as good as your own constantly tweaked hormones. I would have no issue losing the boobs or even uterus, but I would think looooong and hard about ovaries. The side effects are just impossible to fully predict. And losing them doesn't drop your risk to zero, cancer can still grow in the vagina. I doubt you'd geld yourself without a lot if thought and need, luj.

Er, no, Luj, five is not infinitely more than zero. It's five more than zero. Once you've had an organ, you can develop the cancer of that organ---a quick google turns up plenty of women who developed ovarian cancer after having an oophrectomy. Once you are born with breasts, or a uterus, or ovaries, there is no reducing risk down to zero, and there's plenty of reasons why reducing risk from 50% might not be worth early menopause.

Sabrina,

Getting a mastectomy, no matter how good your doc & implants are is a serious procedure that leaves ugly scarring. She was lucky she got to keep her nipples. She didn't just go in to get a tit job. Tit jobs are painful enough, but the fact they did tests on her nipples, removed her boobs by scraping her basically,, stretched out her skin with pre implants, then finally put the implants, positioned the nipples, sewed her up. Ouch!

She is very brave, being brave & smart enough to get tested (a lot of women don't want to know) , accepting her chances, being responsible to her children and removing them.

As for speaking publicly bravo. That is brave. I am not a public person but it's something I would publicly admit and encourage women to get tested and remove the boobs if wanted/needed.

She wrote a thoughtful little piece on The New York Times, she didn't go on a media circus a la Kim Kardashian.

Tabs

Ppen,

I'm not dismissing the severity of what she went through. I am not saying that her decision didn't take courage nor am I downplaying the emotional and physical toll it must have taken. I also applaud her for being pro-active about her health. I questioned her motives for going public with it when she's been able to keep it so private up until now. That's all.

I still do not doubt that she could have plastic surgery. I didn't say it would be easy, just that she could have kept it private if she had chosen too. She certainly has the financial means to do so. Unless she's planning on doing full frontal nudity, no one would noticed. Now, to your point... her appearane is drastically changed by this and would be noticed by her fans. In that case, I can see mentioning it after the fact but unless she is actually planning on doing another movie anytime soon, why bring it up, now?

I am skeptical that she went public with it to raise "awareness" to anything other than herself. Sorry. When you've managed to avoid being in the public eye for something THAT serious, and then you suddenly decide to come clean, your motives aren't about "the public". I have worked in "the biz" to some degree since I was a kid. This kind of thing is great for PR and someone in her line of work isn't naive about that. Just like her work with the UN gets press, so will this. That doesn't mean she didn't have the best of intentions when making the decision to do have the procedure, but I don't find it too hard to believe that she would capitalize on it a bit either. I'll agree that she's not being trashy about it but while this statement is touching and well done, it isn't going to hurt her from a PR standpoint. That's all I'm saying.

In fact, I don't see why anyone should "go public" about anything like that. It's no one's business but yours, your doctors, your immediate families, and your employers should it effect your job. Otherwise, why announce something like that unless you want the attention that comes with it?

Sidebar: Frankly, I am one of those women that is sick of hearing about "breast cancer awareness". Cancer is cancer. Cancer sucks. Why is breast cancer given so much more attention than the other cancers out there? Susan G Komen has made quiet the business out of raising "awareness", me thinks.

Going back and reading it, she DID have the implants sooooo... I question her bringing it up even more now.

Sorry. There was no need to go public. From a celebrity who claims to value her privacy, I doubt her motives.

I will admit that I am biased when it comes to Jolie. She has never struck me as a "sincere" person and this doesn't change my mind. I wish her the best in recovery, and for her childrens sake I wish that she lives a long, healthy life, but I cannot accept that this "reveal" was about anything other than getting attention.

>> Every time she goes out in a tight sweater someone's going to write an article about her tits from now on.

The more things change, the more they stay the same.

A couple of things. from the hype, you would think that the only enemy to women's health out there is breast cancer.

Most women who develop breast cancer, do so when they are quite elderly.

What type of breast cancer does she now have only a five percent chance of getting? It isn't one disease you know, and some types can be easily treated by lump removal alone.

Catching breast cancer early, is not the miracle cure that people think it is. There is a lot of hype out there, and I am suspicious that radical double mastectomy to prevent breast cancer is the scientific equivalent of that low fat high carb diet kick, the mainstream medical community is still stuck on.

Well I think coming out publicly about it is something that is great.

There are things to keep private but this is something that helps a lot of women gain awareness. I certainly didn't know how high the chances were for that gene. I didn't even think about having a mastectomy if I had it. I didn't even think of getting tested till now.

I've come out in my circle (and as publicly as i can) about the anti psychotics I take. I know other people that have done so before me and their stories really helped me.

I have a friend who was molested as a child and I think she mentioned Terri Hatcher coming out & facing her uncle and talking about it really helped her.

There are tons of reasons to loathe celebrities, them coming out about this kind of shit isn't one of them.

On an aside Jolie strikes me as very weird but not a super attention whore like most actors.

As for never telling anyone-you KNOW there would be magazine spreads showing her at X event last fall and at Y event this summer, with different boobs, saying she got a boob job.

If she DID tell for publicity (like she and Brad are ever lacking in that) so what? It brought it into the public eye and will help women who either 1) need to be tested or 2) have been and are scared or 3) did the surgery and feel unsexy or less womanly.

Great point momof4.

I think she is a very smart woman, but I'm not quite willing to call her heroic.

Let's see...drastic reduction in chance of cancer vs. minimal chance of dying on the operating table, lots of money for the best doctors,brand-new set of breasts, totally blowing Jennifer Aniston out of the water, followed by admiration and adulation of family and general public...win, win, win, win, win.

As for the ovaries: Early menopause is a bitch. I have a friend who had her ovaries and uterus removed recently, and she is having a really rough time. There's the cosmetic stuff, like thinning hair, weight gain (and a change in fat distribution), but there are also illnesses, like osteoporosis, that are more likely after menopause. Not to mention the crazy hormonal swings.

I admire Jolie for doing it, and for admitting it openly. Yes, she has the money to make this easier than it would be for a lot of people, but she makes her bank off of being a sex symbol. To admit that your breasts have been cut off is huge. The procedure itself is a tremendous mutilation, even if your breasts don't make you millions of dollars.

Hell, coming out as *gay* isn't even courageous anymore, it's become positively *trendy*,

Posted by: Jason at May 14, 2013 6:44 AM
___________________________________________

But given that Oct. 12, 1998 wasn't so long ago (Matthew Shepard's murder) I'm guessing it depends on where you live in the U.S. If you're not a celebrity, you could be in danger. Or, at least, out of most jobs.

Not so long ago, the only way to be a gay person, non-religious, or childfree was to pretend that such horrible people didn't even exist. Then the tide shifted - but individuals were still expected not to talk about their "lifestyles."

Finally, it was acknowledged that people who DO dare to talk about who they really are and what they believe (namely, not acting like mindless sheep) get discriminated against or at least ostracized, and that it was time to talk even louder and demand some common courtesy. Hence, Sam Harris' book "The End of Faith" (of course, British philosopher Bertrand Russell wrote HIS books about 80 years earlier, but there haven't been too many outspoken people like him) and a couple dozen books by different authors on being childfree - as well as the harsh but often intelligent site, Bratfree. One point that both the non-religious and the childfree make more often than they used to is that neither religion or breeding is harmless - especially when done carelessly.

Most women who develop breast cancer, do so when they are quite elderly.

Posted by: Isab at May 14, 2013 1:26 PM
___________________________________

Quite elderly? As in, over 70? Cite, please.

I don't pay any attention to Hollywood (and I mean ANY - I see maybe 1 movie in theaters every 2 years and don't have TV). So I can say that I don't really need to know about anybody's boobs if that person isn't me, or an immediate relative. For that matter, I've got plenty of relatives whose boobs are none of my business.

I don't think her boob decision is anything more than that - a personal consideration of the risks involved in surgery versus not, waiting to see, etc. She made her decision, just like a whole lot of other women have (I know a few). Sure, it's a good topic to bring up periodically, but this would be better as a PSA (some women are at risk for XYZ, talk to your doctor about your risks and possible preventatives) than to talk about somebody's boobs.

"But given that Oct. 12, 1998 wasn't so long ago (Matthew Shepard's murder) I'm guessing it depends on where you live in the U.S. If you're not a celebrity, you could be in danger. Or, at least, out of most jobs"

If you think the Matthew Shepard murder was either wholly or mostly about his being gay, you haven't read anything about the case other than the mainstream media propaganda.

I know the prosecutor in that case, and most of the professionals involved considered it a robbery gone wrong. One of the guys who killed him is actually gay, but that fact didn't fit the narrative of the young gay student victimized by the hicks in Hooterville because of his sexuality.

Even Camille Paglia wrote about how bogus the whole thing was.

http://www.cdc.gov/cancer/breast/statistics/age.htm

The ironic thing here is Angelina Jolie's mother didn't die from breast cancer. She didn't have it. She had ovarian cancer.

I would have no issue losing the boobs or even uterus, but I would think looooong and hard about ovaries. The side effects are just impossible to fully predict. -- Momof4 at May 14, 2013 11:45 AM

Just a side note to this. In a women, the uterus is also a gland that produces testosterone. It doesn't produce, usually, anywhere near the what a male's testes do; but many women notice a drop in sexual needs if they have their uterus removed.

So I go back through the files, and it turns out that Isab spoke up in one of our earlier discussions about Shepard.

Reading that reminds me of how much fun it was to disagree with Jody (and be right).

> she makes her bank off of being a sex symbol. To
> admit that your breasts have been cut off is
> huge.

Agreed... But fame of her type (and certainly that of her example) has always been about big-gesture theatricality. She's had a couple decades of fame, including work in international politics (the silly, United Nations press-conference kind).

She's mostly harmless; even when she has silly political ideas, she's not an opinion leader. Quite the opposite: Hollywood makes money through instinctual sensitivity to popular taste, not leadership of it. Like Paris Hilton or a Kardashian, she ceases to exist when you ignore her. No one could wish her ill, certainly not the illness for which she's proven to be at risk— If you've ever seen someone die from these horrors, you wouldn't want that to happen to someone just for selling you a ticket to a bad movie.

She's has made plenty of money doing the lust-worthy ingenue, the action heroine and the femme fatale, but those opportunities were probably diminished for an actress approaching 40, no matter how well-known she was. (Hollywood has no use for older women, right?)

Even if publicity of this nature can be reduced to a macabre observation of the outcomes from her grim healthcare probabilities, she seems like the sort of person who'd be happy to add it to her attention portfolio... Which was never composed for those with gentle tastes.

(And for the record, I wished I'd put more stock into Isab's comments about Shepard when she made them.)

And sorry for the "she's has," which I done did write type in the earlier preceding comment posting.

Yes, we know...

But we're still glad that someone try.

Most women who develop breast cancer, do so when they are quite elderly.

The ironic thing here is Angelina Jolie's mother didn't die from breast cancer. She didn't have it. She had ovarian cancer.

Perhaps you should read up on the gene associated with this. There is a difference between Jolie's case and, say, mine (my mother had breast cancer in her 60s and does not have the gene mutation so a proactive mastectomy would not be of much benefit to me).

Er, no, Luj, five is not infinitely more than zero. It's five more than zero.

And Jenny shows she was napping during math class in school...

Er, no, Luj, five is not infinitely more than zero. It's five more than zero.

First off, what Astra said

Secondly as long as we are ignoring the rules of math . . . .

On a D10 (ten sided die for those of you unfamilliar with D&D) 90% is only 4 more than 50%

So as 5 is larger than 4 I still win

I have read up on the BRAC1 gene, and I still fail to see how having your breasts removed will lower your odds of getting ovarian cancer, or all the other cancers associated with defects in this gene.

This is a bit like removing your front door, so a burglar can't get in there, while ignoring the fact that you have six ground floor windows in your house.

I still fail to see how having your breasts removed will lower your odds of getting ovarian cancer,

She also suggests that removing her ovaries is next.

"I still fail to see how having your breasts removed will lower your odds of getting ovarian cancer,

She also suggests that removing her ovaries is next."

So I guess, the next question is, how many parts are you willing to chop off to reduce your chances of getting something, that may or may not prove to be fatal, or not affect you at all for another twenty of thirty years?

The dangers of screening aside, I would be looking at doing all I could to make healthy lifestyle choices, that would reduce my chances of getting cancer, rather than chopping out parts, one set of organs at a time.

This strategy is starting to resemble the ill fated assault weapons ban.

As I understand it, breast cancer is specific to breast tissue (ducts, etc).

Posted by: Amy Alkon at May 15, 2013 8:21 AM

Absolutely true, but there are literally hundreds of different types of breast cancer, and a defect in BRAC1 sets you up for an increased risk of all sorts of different cancers, not just breast and ovarian.

The truth is, medical professionals have no idea how many women carry this defective gene who don't get cancer, because for 3000 dollars this is not going to be a test you get on a lark unless, like Angelina Jolie, you are rich and have a close relative or two, who has had an aggressive cancer.

Therefore, their 87 percent risk reduced to 5 percent with the double mastectomy is a number they basically pulled out of their ass.