"You were Angelina before Angelina."--Dr. Andrew Ashikari

The wise and beautiful Angelina Jolie after publically
announcing her decision to do a Prophylactic Mastectomy
due to familial high risk and her BrCa 1 mutation

So said my Breast Surgeon, Dr. Andrew Ashikari to me this morning, as I (happily) completed my 35th bi-annual breast exam, 17 years after my breast cancer and 13 years since he performed  my own nipple sparing, subcutaneous prophylactic double mastectomy.  There.  I said it.

Yup.  Me and and Angie are BrCa 1 twins.

Yesterday was a HUGE day for the high risk community.  Angelina Jolie, one of the world's great beauties and biggest stars, announced that she chose to do a prophylactic mastectomy. Because Angelina inherited a BrCa 1 mutation (presumably from her mother, who died of ovarian cancer at 56,) her risks were a staggering 87% chance of getting breast cancer in her lifetime.  As a motherless mother, she chose to enormously reduce her own risk, for the sake of her well being and that of her family.  Bravo Angel Angie!

Much will be made of her advantages of her being able to afford genetic testing.  That's a good thing and something she knows she is appropriately shining a spotlight on.  Myriad Labs has despicably held the high risk community hostage with their patent on these tests, which run about $3000 and is often covered only after much battling with insurance companies, if at all.  



A decision about whether or not this patent is legal is before the Supreme Court as of this writing.  Hopefully, Myriad will lose and other companies will be able to bust open their monopoly, thus making these tests more afforadable to women who have strong maternal AND PATERNAL histories of breast and ovarian cancer, as well a pre-menopausal breast and ovarian cancer patients, who are often found to have BrCa mutations.

I refuse to read comments by those who think this is hysterical or radical.  It's neither.  It's smart. It's brave and even harder to do before breast cancer strikes,  because there is still the illusion of breast health, fragile as it may be.

I know many, many women in the high risk community.  I don't know a single one who has ever regretted doing their prophylactic mastectomy.  I do, however, know of women who knew of their risks, chose surveillance and got breast cancer anyway.  Regret... knowing they knew and didn't act, is often the bitterest pill to swallow.  Trust me.  You don't want to let the cancer genie out of the bottle if you don't have to.

Angelina, however, may have chosen a more complicated surgical path than is necessary. 3 steps when it could have been achieved in one. Perhaps she didn't even know it was an option.  Now you will;

13 years ago, when I asked my own surgeons do perform this surgery after finding out about my own BrCa 1 mutation, 4 years after my initial breast cancer diagnosis, I was a pioneer of sorts too.

Though ultimately, I did have to do a two stage procedure, 3 years later Drs. Roy and Andrew Ashikari (Surgical Breast Oncologists 914-693-5025) and Dr. C. Andrew Salzberg (Board Certified Plastic Surgeon 800-433-7410), pioneered a way to do a ONE STAGE prophylactic subcutaneous nipple sparing mastectomy. 

The nipples are biopsied on the table and if all is clear, they are spared.  Through the use of a material called Alloderm,  a skin pocket is created, thus removing the need for "expanders", (which include painful saline stretching over several months) and a second revision, final surgery.  These great surgeons are 3 of my personal heroes, brilliant, kind and compassionate.  I was delighted to be honored by them at a fundraiser I chaired for the Ashikari Breast Center 2 years ago.

This is huge, and IMO, will be the future of reconstruction.  These Drs. have successfully performed this procedure on hundreds of women who fly in from all over the country and have taught their method all over the world to other surgeons.

I proudly was the person who brought this to the attention of the high risk online support group FORCE, too late for me, but not for my courageous FORCE sisters Sharon and Mayde, two of the first, who graciously shared their experiences and helped others go down this path, with beautiful, natural looking results. "Sisters"  helping "Sisters". The gift that keeps on giving.

Sister Angie, thank you , thank you, thank you.  I wish you and your family good health and happiness, always.  You moved the world ...

xox,
DD