Doctors opinions vary over Jolie mastectomy decision

Doctors opinions vary over Jolie mastectomy decision

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by KGW.com staff

kgw.com

Posted on May 14, 2013 at 4:51 PM

Updated Wednesday, May 15 at 6:22 AM

PORTLAND -- Angelina Jolie announced Tuesday that she decided to have a double mastectomy to reduce her risk of breast cancer after she learned she carries the “faulty” BRCA1 gene.

Area doctors had divided opinions over recommending similar procedures for women who also carry the mutant gene.

Dr. Alison Conlin, a Providence Medical Oncologist specializing in breast cancer treatment, said she supported Jolie’s decision.

“I read her piece and was really impressed with how thoughtfully she put things out,” Conlin said. “Her future risk of breast cancer is so much higher than even a woman whose mom had breast cancer."

Still, she stressed that only a small percentage of women have the BRCA1 gene.

“For those five percent of women, this test is important for them to get and then figure out what next steps are appropriate for them,” she said.

Dr. Rodney Pommier, Professor of Surgery at the Knight Cancer Institute at OHSU, said he rarely recommends this type of surgery as a preventative measure, especially for women who haven’t been diagnosed yet with breast cancer.

“The data that this actually changes the ultimate survival and the outcome of the patient are sadly lacking,” said Dr. Pommier.

By the time many women consider undergoing a mastectomy, he said, the cancer could have already spread to other areas of the body.

Jolie's decision is not necessarily the example to follow, according to Dr. Pommier.

"If you remove the breast, you are not going to be diagnosed with a tumor of the breast. That doesn’t mean you already don’t have the disease," he said.

Dr. Pommier said in many cases, chemotherapy or hormone therapy can offer better results than a mastectomy.

Even if a woman decides to get the test, the price can be prohibitive.

"It's over a $3,000 test. It's not for everyone,” said Conlin. “But if you do have a few family members who have had ovarian cancer, breast cancer melanoma or even prostate cancer in your family, you should talk to your doctor."

Dr. Allen Gabriel, a plastic surgeon at PeaceHealth, said insurance companies will often cover the reconstructive surgery after a mastectomy. 

"Let's say you're gene positive and undergoing a mastectomy. The insurance companies most likely will cover your reconstructive options," said Gabriel.

One thing doctors did agree on is the importance of talking to a doctor before making a decision about treatment.

KGW Reporter Erica Heartquist contributed to this report.

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