Inside the ‘Angelina Jolie effect’ on breast reconstruction

I was deeply moved by Ms. Jolie’s journey of recovery and reconstruction after her shared experience of breast mastectomy. As a member of her surgical team, I learned that she had a significantly elevated risk of developing breast cancer after undergoing genetic screening. After learning this, she courageously elected to proceed with a double prophylactic mastectomy five years ago.

Today, the media has dubbed this woman “Angelina Jolie” as an example of how one woman has made a tremendously positive impact upon the lives of others and continues to be an ongoing source of inspiration for me. The concept of preventative mastectomy and reconstruction has now raised awareness among a greater number of women, inspiring increasing numbers of high-risk women to undergo genetic screening.

As a result of the widespread recognition caused by the “Angelina Jolie effect,” I have personally witnessed women whose lives were potentially preserved.

Over the course of a woman’s life, the detection of these genetic alterations aids in evaluating the likelihood of developing breast cancer. In addition to numerous others, comprehensive genetic panels now evaluate for a range of alterations – including those impacting the CHEK2, PALB2, PTEN, and TP53 genes. Presently, we comprehend that BRCA mutations are just a couple of the numerous alterations that greatly increase the risk of breast cancer. The evaluation of breast cancer risk has continued to advance in the last five years.

We now acknowledge several factors in an individual’s personal and familial background that may deem genetic testing recommended. These factors encompass:

  • The medical history of an individual regarding breast cancer, which could encompass cancer in both breasts or a diagnosis of triple negative breast cancer prior to the age of 60.
  • Individual background of ovarian cancer.
  • A family’s medical history involving breast cancer occurring prior to the age of 50 in two or more immediate family members, such as a mother, sister, or daughter.
  • Close family members of individuals with Eastern European Jewish heritage who have a family history of breast, ovarian, or pancreatic cancer.
  • A nearby male family member with breast cancer.
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    It is important to consider her overall health and her willingness to tolerate the risk when estimating her lifetime risk of breast cancer. It is not the right choice for every high-risk woman to undergo a preventative mastectomy. It is very personal and important to consider both the nature of this decision and its major factors. The risk of breast cancer drops by approximately 90% among women who undergo prophylactic mastectomy.

    Once the decision is made to undergo prophylactic mastectomy, it is very important for the plastic surgeon to address the patient’s approaches that include the use of implants as well as creating new breast tissues that are one’s own. It is believed that it is very important for the surgeon, acting as a plastic surgeon, to consider the reconstructive options.

    A personalized and unique plan must be developed for each patient. In order to arrive at this, all aspects of the patient’s overall health and lifestyle, body type, and preferences should be taken into account.

    To regain complete wellness and attain or sustain optimal well-being, reduce the potential for future complications to assist her in attaining a strong stance, it is the prerogative of every member of her team. The leader of her team is the patient, however, additional members may consist of a genetic specialist, an internal medicine physician, medical and radiation cancer specialists, as well as general and reconstructive surgeons. It is crucial for each patient to dedicate the necessary time to establish a reliable support network throughout the journey, as it is of utmost importance.

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