When Angelina Jolie announced in the New York Times, in May of last year, that she’d undergone a radical mastectomy, she wrote, “Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of.” Her bravery was widely applauded, and she became “the new, gorgeous poster woman” for the procedure, which she chose to have because, like her mother, who died at age 56 from cancer, she carries the BRCA1 gene that increases the risks of both ovarian and breast cancer. In the wake of her announcement came a rash of news stories about other women—some as young as 21—who’d opted for the surgery, along with tweets by breast cancer survivors calling Jolie “so brave” (Sheryl Crow) and “admirable,” among other accolades.
Now, belatedly, science is catching up to the publicity buzz.
NPR has reported on a study published in JAMA on Tuesday showing that women who undergo radical mastectomies in the early stages of breast cancer have no greater survival rate than those treated more traditionally, with a lumpectomy and radiation therapy.
The authors of the study looked at all 189,734 California women who were diagnosed with early-stage breast cancer between 1998 and 2011, and found that those who underwent radical mastectomies had an 81.2 percent 10-year-survival rate, compared to 83.2 percent for those with lumpectomies. This despite the fact, the authors say, that the women who had breast-removal surgery were generally younger, richer, and white, with better medical care. Radical mastectomies performed for prophylactic reasons have been proliferating; by the end of the study, a full third of California women under age 40 diagnosed with early-stage breast cancer were opting for the procedure despite the fact their cancers were easily treatable.
Jolie, of course, hadn’t even been diagnosed with cancer, only with the gene mutation. As the NPR story notes, the overwhelming majority—95 percent—of breast cancers aren’t even caused by BCRA mutations. And, it adds, “Doctors have been increasingly concerned that women are choosing bilateral mastectomy in the mistaken belief that it eliminates their future risk of cancer.” Which is exactly what Jolie proclaimed in the Times: “My chances of developing breast cancer have dropped from 87 percent to under 5 percent.”
I’m not about to say Angelina Jolie cut off her breasts for nothing. I’m not a doctor. But that’s the point: Neither is she. Yet in our insanely celebrity-aping culture, some women are going to hear boldface names telling Jolie she’s admirable and brave for her choice and think that they’ll be admirable and brave for following her lead. That’s how we end up with idiots like Jenny McCarthy, and outbreaks of measles and mumps.
It’s your body, ladies. Do as you want with it. But listen to science, not movie stars, before you do. That’s taking control.
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