HER NATURE HIS NURTURE

a his & hers weblog of worlds apart

BReast CAncer: An Unimaginable Decision

Surgery or Surveillance?

At the risk of becoming overly focused on celebrities with genetic conditions, I can’t help but comment on Christina Applegate’s interview on Good Morning America last week. She speaks openly about her recent breast cancer diagnosis and reveals that she has a genetic mutation in her BRCA1 gene that makes her at a very high risk of developing breast and/or ovarian cancer. In what some are calling a controversial decision, Applegate opted to forgo radiation and chemotherapy treatment and chose prophylactic removal of both breasts instead.

After watching the documentary In the Family, I have a newfound appreciation for the agonizing decisions about surgery that women with BRCA mutations are faced with. Genetic counselors learn to present BRCA-positive women with a choice: prophylactic removal of the breasts and/or ovaries OR close surveillance using mammography, MRIs and ultrasounds with the hope of catching developing cancer early. This film, which brought a room full of GC’s to a deafening silence, very clearly illustrates the lack of support for women who choose the “surveillance” option. Time and time again the heroine/director Joanna Rudnick is gently pushed towards choosing surgery by everyone around her.

Here’s the movie trailer:

Christina Applegate doesn’t talk about how long she has known about her BRCA status, nor does she speak about her decisions surrounding ovarian cancer screening or surgery. Given the gravity of the decision I imagine that she prefers to keep this information private, and rightly so. She does, however, credit her breast MRI with saving her life, and has committed to creating a foundation that will raise money for the costly MRI screening for women at high risk for breast cancer. I applaud this effort – especially because it will provide some much needed support to those who would like to choose surveillance.

In the Family will air as part of POV on PBS on October 7, 2008. Although it is very heavy, I highly recommend it. For more information about hereditary breast and ovarian cancer, click here or here.

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