COMMENTARY — Angelina Jolie is a nice lady with high ideals. Jolie and her partner Brad Pitt have certainly done a lot to help raise awareness about the situation in post-Katrina New Orleans, my hometown.
Nobody wants to say a bad word about her. Least of all me.
But today I have to admit that I’m pretty much shaking with anger. Angelina Jolie’s “My Medical Choice” published this morning in The New York Times revealed that she has received a double mastectomy to remove healthy breasts because she carries the BCRA1 gene which greatly elevates the risk of developing breast and ovarian cancer.
By having her breasts surgically removed, she said that she reduced her chance of developing breast cancer from 87 percent to 5 percent.
What she also did, of course, was increase her chances of losing her breasts from a “maybe one day” to a guaranteed 100 percent. Her breasts are gone.
Because Angelina Jolie is a millionaire with access to the best doctors in the world, she can guarantee that her post-mastectomy reconstruction will go as well as it possibly can — including advanced techniques for preserving her nipples and skin.
Salon’s Joan Walsh pointed out that most women don’t have those resources. Walsh, whose mother died at 45 of breast cancer, was also high risk, and she also had a doctor who recommended double mastectomy.
Fortunately for Walsh, she had another doctor who didn’t agree. She didn’t get the surgery, and she did not in fact develop cancer.
As Walsh tactfully put it: “Low income and younger women might have reasons not to opt to remove their breasts. It’s unlikely poor women would find the level of care Jolie did, with careful attention to protecting their nipples (and with it, possibly, sexual sensation) and aesthetically pleasing reconstruction.”
I’ll be less tactful. I think any living human being on this earth “might have reasons not to opt” to remove a healthy body part because of something that might — or might not — happen in the future.
So far, celebrities like Sheryl Crow, Kristen Bell, Elizabeth Banks, Marlee Matlin, and others have tweeted their support to the world. They used words like “brave” and “courageous.”
Well, far be it from me to disagree with all these glittering stars, but what’s particularly brave about removing a healthy body part before there’s any need?
We don’t allow people to do harm to their bodies to make themselves feel better. Do we?
The thing is, we have a perfectly reasonable noninvasive alternative to double mastectomy — early detection. It works. In the 21st century, improved screening and treatment for breast cancer means that your chances of survival have soared. The five-year survival rate for breast cancer in women aged 40 to 74 is 85 percent — with the highest rate of survival for well-to-do women like Jolie.
One problem I see with high-profile people like Miss America contestant Allyn Rose and A-list star Angelina Jolie choosing double mastectomy is the pressure they put on other women. They say they’re doing it to be there for their children.
In a Facebook debate on the topic, a poster described the very argument I fear: “I would have made the same choice. She put her family first.”
Isn’t there an implication here that women who decide to keep their breasts are being selfish?
Another problem is that people aren’t being realistic about what Jolie’s surgery entailed. Here’s a representative comment: “Good for her for taking control of her body before cancer does. Although we have many treatments for cancer they are all still so painful and life changing.”
You know what? Amputation followed up by multiple reconstructive surgeries is also painful and life-changing — with the difference that a woman may always have the haunting doubt that it may have been unnecessary. Let’s not pretend double mastectomy is a twenty minute eyelift. It’s major surgery, with all the risks of complications and a recovery time of months.
And one other thing: Jolie said that she has been open with her children. “[T]they know that I love them and will do anything to be with them as long as I can.”
Talk about the mother of all guilt trips.
For me, the worst message from the Jolie surgery is that breast cancer is so fatal, so terrible, that it’s better to just go ahead and proactively cut off your breasts. That simply isn’t true, not in 2013.
But if I believe that my choices are get my breasts cut off now or die later, then I’m just going to freeze up and do nothing. Angelina Jolie called her surgery a message of empowerment. But, for me, it’s a message of fear.