Doctor: Mastectomy not only choice for women at risk of breast cancer

May 15, 2013 4:34:16 AM PDT
Following the news that actress Angeline Jolie had a double mastectomy, a Chicago oncologist wants women to understand that her condition- a defective BRCA1 gene- is not common.

Mutations in that gene and another called BRCA2 cause an estimated 5- to 20-percent of breast cancers. A genetic blood test can detect these mutations. For those who carry the mutation and choose to have their breasts removed, there are newer ways to rebuild, which has made a double mastectomy a more appealing option.

"With an incision underneath the breast so the incision can be invisible the breast is removed the nipple is saved and that's then replaced with either someone's own tissue or fat from abdomen or implant," Dr. David Song, University of Chicago Medicine, said.

Jolie's decision to go public with her choice by writing about it in the New York Times is drawing both praise and criticism. This type of pre-emptive surgery has divided parts of the medical community.

University of Chicago oncologist and genetic expert Funmi Olopade is one of the world's leading authorities on hereditary breast cancer.

"I said, 'No. We're not going back there.' Women are not going to go and have mastectomy out of fear and anxiety," Dr. Olopade said. She said too many women are frightened by the statistics and see surgery as their only hope.

"The estimates are not 87-percent for every woman. In fact, it could be as low as 37-percent in some women," Dr. Olopade said.

Dr. Olopade said her own research is showing close monitoring with MRI scans are effective at spotting this cancer very early, when it's treatable. For some women, certain drugs can also lower the risk of breast cancer.

"You know there was a time when the only choice women had was to have breast removed, to have radical surgery, but we are way beyond that now. There are options for women, even the women with the highest risk," Dr. Olopade said.


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