When Angelina Jolie announced last month that she had bilateral prophylactic mastectomy to reduce her high hereditary risk of breast cancer, newsrooms all over the world scrambled to cover the story.
A local reporter called me to discuss Jolie’s drastic action; when our conversation shifted to breast reconstruction, the reporter asked, “Well of course Jolie had reconstruction, what woman wouldn’t?” This question might seem to be logical (and a foregone conclusion) to those who are unfamiliar or untouched by mastectomy. We routinely replace worn-out hips, out-of-whack knees and other faulty body parts; why then, wouldn’t it also be a no-brainer for women to opt for reconstruction after losing such an intensely private and personal part of themselves?
While many women consider breast reconstruction to be an option that they can do without, each year tens of thousands of women who lose their breasts to either treat or prevent cancer have post-mastectomy reconstruction. For high-risk women like Jolie, the possibility of returning to a near-normal (or improved) natural feminine profile eases the very difficult decision to have preemptive mastectomy. As one woman explained reconstruction to her child, “It replaces the stuffing in Mommy’s breast.” That might be a bit simplified, but it’s accurate: reconstruction doesn’t restore sensation or the ability to breastfeed, but it does replace breast tissue that is removed during mastectomy with implants and/or a woman’s own excess fatty tissue from elsewhere on her body.
Jolie made informed and carefully considered decisions that were right for her, but they are not the only options, and other women, even those with a similar level of risk might prefer a different path.
With her double mastectomy and reconstruction now behind her, Jolie, who has been called “the most beautiful woman in the world” wrote, “…I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity.” She certainly didn’t have to go public with her story. (Arguably the priority of many in her profession would have been to remain quiet on this intensely personal issue.) By sharing her experience, Jolie opened dialogue about the power of individual choice, while encouraging women to make their own informed decisions.