In 2013, American actress Angelina Jolie made headlines after she chose to undergo a preventative mastectomy to reduce her risk of developing breast cancer, a concept that was unfamiliar to many who heard the news for the first time.

The reason given for this act of preventive medicine was that she carried a BRCA1 gene mutation, which is associated with an increased risk of breast and ovarian cancer. She also had a relevant family history that further increased her risk, as her mother died of ovarian cancer.

The news generated major global headlines, sparking widespread public discussion and a surge in information-seeking about genetic testing and preventive care.

A radical choice

The actress’s choice to undergo a preventative double mastectomy stunned the world. Jolie willingly chose to remove both breasts that had no evidence of cancer at that time, but were at risk of cancer development in the future.

A preventative double mastectomy is a radical choice because it means that women lose their healthy breast tissue as a means to prevent cancer from potentially occurring in the future. Some have wondered whether this was a step too far, or whether she was simply taking the painful but necessary steps to secure a better future for herself and her loved ones.

The important thing to consider is that despite public commentary, the decision was hers and hers alone. If you are considering undergoing a preventative mastectomy, know that you’re not alone, and your decisions should be based on what is best for your future.

A major surgery

A preventative mastectomy is not a decision that should be taken lightly; it is a permanent decision that is best made after consultation with doctors and loved ones. It should be stressed that preventative mastectomies are only reserved for patients deemed to be high-risk; this is by no means a routine procedure. But if genetic factors and family history suggest that the scales tip in favor of future cancer, it may be appropriate.

A preventative mastectomy is not a 100% elimination of cancer risk. It lowers the risk substantially, but the risk is not totally gone, as there is still breast tissue left over. However, it may bring patients peace of mind, with the sense that a life without overwhelming anxiety about breast cancer may be possible.

This radical procedure is not recommended for everyone; again, it must be stressed that it is typically reserved for extremely high-risk patents. The removal of healthy breasts may deal a major psychological blow to women, so this procedure should only be undertaken if patients are fully aware of the implications of this surgery. However, advancements in breast reconstruction surgery may soften the blow should patients pursue this path.

Recovery and side effects

Recovery from a preventive mastectomy is similar to a standard mastectomy. Initial healing typically takes about three to six weeks, but could take eight or more weeks if reconstructive surgery is performed.

If you are considering this procedure, here are some of the risks and potential side effects of mastectomies you may want to be aware of:

Numbness and lack of sensation
Limited range of motion and stiffness
Lymphedema, or swelling caused by fluid buildup
Emotional or self-image changes
Short-term (temporary) breast swelling
Breast soreness
Hardness due to scar tissue that can form at the site of the cut (incision)
Wound infection or bleeding
Swelling (lymphedema) of the arm, if lymph nodes were removed
Pain in the breast that has been removed (phantom breast pain)

Every surgical procedure comes with risk, but the risk of severe or long-term side effects from a preventative mastectomy is low. If you are experiencing any of these symptoms after a mastectomy, contact your doctor. There are medications and therapeutic options they can prescribe you that may be able to help reduce your pain and speed your healing.

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