The media was very excited to report on Angelina Jolie’s decision to undergo prophylactic nipple sparing mastectomy for her BRCA gene positive status. Ms. Jolie should be commended for making public her very private choice so that others who might never be interested may learn about the prophylactic mastectomy issue.
The overheated blogging that has ensued on the issue is better left to others. From my perspective, patients with BRCA positive status, as well as other high risk women, should have their options thoroughly discussed with a genetic counselor and with a medical and or surgical oncologist as indicated. In addition, more and more women diagnosed with breast cancer are choosing to have their non cancerous breast prophylactically removed and reconstructed at the same time as the cancerous one to maximize symmetry and minimize worry.
Women should then understand that undergoing surgery is a trade off of risks and benefits and that the process may or may not be completely smooth. In the optimal setting, chances of beast cancer are reduced, problems during the reconstruction are minimized, and the result meets the patient’s expectations.
Mark D. Wigod, MD, FACS, providing cosmetic and reconstructive plastic surgery to Boise, Meridian, Treasure Valley and Southeastern Idaho.