Anyone who has been following the news recently is probably well aware Jolie had a double mastectomy and her reasoning behind the decision to have the procedure. In a piece published in the New York Times she explained that she is a carrier of the BRCA1 gene that has been linked with a much greater likelihood of developing breast cancer.
Her mother also had them and died prematurely at the age of 56. Even more recently, Jolie’s aunt (and sister of her mother) also died from breast cancer. Debbie Martin was just 61 years old when she passed away. Martin also tested positive for the BRCA1 gene but didn’t know that until she already had cancer.
Debbie Martin’s husband said he was proud of Angelina Jolie’s decision to have the double mastectomy in order to reduce her chances of developing breast cancer. (That chance has been cited as 87% for breast cancer and 50% for ovarian cancer.)
According to Stanford Medical Center, the average lifetime risk for breast cancer development associated with the BRCA1 gene is 65% and 45% for the BRCA2 gene. (The Stanford source goes on to say it is Ashkenazi Jewish individuals who have a greater chance of having BRCA1 or BRCA2.)
After completion of the surgery, Jolie’s breast cancer risk was estimated to have been reduced to less than five percent. So, there isn’t much issue at all with her decision, due to the genetic predisposition in her family.
However, the vast majority of breast cancer cases are not associated with BRCA1, as was pointed out by the Environmental Defense Fund: ‘Approximately 90-95% of breast cancer cases cannot be attributed to BRCA1 or other genetic mutations.’
What has been missing from press coverage about Jolie’s double mastectomy is the potential connection between environmental factors and breast cancer.
As the Breast Cancer Fund wrote in an overview of the relationship between contaminants and the disease, ‘With more scientific evidence emerging practically daily, it’s clear: the chemicals in our environment play a role in altering our biological processes. It’s clear that our exposures to toxic chemicals and radiation are connected to our breast cancer risk.
On a positive note, our exposure to chemicals and radiation is something we can begin to control—through personal, corporate and political action. Get to know the chemicals that have been linked to breast cancer and take action to reduce your risk.’
Another EDF article says, ‘Breast cancer is largely a preventable disease. To reduce the risks of chemical exposures, we need tests that accurately detect breast carcinogens, and we need policies that require such testing. These goals are achievable in the near term, but only if we demand them.’
An Institute of Medicine report included some general guidelines for potentially reducing risk, ‘The IOM concludes that women may have some opportunities to reduce their risk of breast cancer through personal actions, such as avoiding unnecessary medical radiation throughout life, avoiding use of estrogen –progestin hormone therapy, avoiding smoking, limiting alcohol consumption, increasing physical activity, and, for postmenopausal breast cancer, minimizing weight gain.
If lifestyle factors like diet, exercise, smoking, stress, alcohol, social connectedness, access to information, literacy and environment do play some role in cancer risk, it seems like quite an oversight by the press to not mention them at all.
Of course, the people who work to raise awareness about women’s health issues will tell you heart disease causes many more women to die each year than breast cancer, but breast cancer sure gets the press.