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Jolie's Double Mastectomy Shines Light On Preventing Cancer


Yesterday in a New York Times op-ed, the actress Angelina Jolie announced that she has had a preventative double mastectomy, to dramatically cut her risk of getting breast cancer. The public revelation stirred up a lot of discussion about cancer and how we treat it. Jolie's mother died of ovarian cancer, at the age of 56. The actress herself carries a gene mutation that puts her at high risk of getting breast cancer and ovarian cancer. The writer Peggy Orenstein says the op-ed resonates with her, but she has some concerns about Jolie going public.

PEGGY ORENSTEIN: I feel that it's really, really important that women recognize that Angelina Jolie is in this very particular group of women that has this genetic mutation. She's not a woman of average risk. And to take her experience and generalize it, either to ordinary women at average risk or even women with a family history - that concerns me.

GREENE: Peggy Orenstein herself is a breast cancer survivor, and also had a mastectomy. She's written about her personal journey in The New York Times Magazine. We reached her at her home, to talk about Angelina Jolie and the effect her revelation might have.

You've actually written about a fear that there might be over-awareness; I think as one cancer researcher you quoted put it, that there might be a culture of fear developing in women.

ORENSTEIN: Women are bombarded with breast cancer. Pretty much everywhere they go now, there's something pink that's reminding them of breast cancer. And the unfortunate result - and this is an unintended consequence - that even as we have an epidemic of breast cancer, the average woman now has an exaggerated sense of her own, personal risk; so that we make decisions that are not in our own best interests.

GREENE: Let me ask you about your own decision. As I understand it, you had breast cancer. Because of that, you had a single mastectomy and were considering removing your second, healthy breast. And tell me your doctor's advice, and what your ultimate decision was.

ORENSTEIN: I had a recurrence of my breast cancer 15 years after my first diagnosis. And when I talked to my doctor, there were a couple things. One is, breast cancer in your breast is not what kills you. Breast cancer, when it goes to your other organs or your bones, that's what becomes deadly. And taking off your healthy breast is not going to change that.

And the treatment that I'm on, a drug called Tamoxifen - that you take for a number of years - which is a really common breast cancer treatment, reduces not only my risk of getting that distant disease that would be deadly, but it reduces my risk of getting a new cancer in my other breast, to that of an average woman.

And that's where this idea of - sort of how we think about breast cancer versus anything else, comes in. So an average risk of a normal person, well, you know, I take a lot of health risks, I guess, in my life - as we all do, you know? You don't always eat right. I have high cholesterol. Sometimes, I eat cheese. I live six blocks from a fault line in northern California.

GREENE: Mm-hmm.

ORENSTEIN: We live with risk, and breast cancer is one of those risks. And when your risk is not particularly elevated, removing a body part has its own risks. I've had a mastectomy. It's pretty tough. And the reconstruction, well, it looks really good - and Angelina Jolie's probably looks better. It doesn't have sensation. So you're going to lose that as well. So again, this is not the situation Angelina Jolie is in. She had to make a decision about a very elevated risk, in a family where there's been significant death from cancer.

GREENE: Mm-hmm.

ORENSTEIN: That's a different situation than where you have not a particularly elevated risk of cancer in your other breast. And so what my doctor said to me - if you ,make a decision to remove your breast, that's a psychological decision having to do with your risk tolerance. It's not a medical decision.

GREENE: Peggy Orenstein, thanks so much for talking to us about this.

ORENSTEIN: My pleasure.

GREENE: That's author Peggy Orenstein. She joined us from Berkeley, Calif.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.