In Greek mythology, Amazons were said to remove a breast in order to better shoot arrows. This week, the world awoke to realize that the breathtakingly beautiful Angelina Jolie had removed both of her breasts in order to better see her grandchildren.
A lot has already been written on Jolie and her decision. For the most part, people are in agreement that her decision makes sense for her. And that last part, “for her,” must be stressed to the women who are in the process of making their decisions or those who will soon be sitting in their doctor’s office being told they are high risk and carry the faulty genetic marker.
I’ve read pieces that call into question the science, hope that Jolie becomes a voice for breaking up the monopoly on the BRCA test itself and far more who fawn over Jolie’s courage. Yet, rare in the pages and pixels spilled over Jolie’s decision is any real framing of what it is to sit where she sat and make that decision.
Yes, the science sucks. The choices women who carry the BRCA gene and have a family history suck even more.
A woman I know, a friend of a friend named Brenda, made this decision a few years ago. So I went to her with my questions as I wonder about any science that says the best way for women to prevent breast cancer is to amputate their breasts. Local newscasts have featured women who stated they decided on double mastectomies because they did not want to live in fear of breast cancer.
And as I read Brenda’s email, I realized an appreciation for that fear.
The alternative for those who have both the BRCA gene and a history with breast cancer is monitoring. This is what she describes as the alternative to a double mastectomy:
Annual mammograms alternating with an annual MRI at a cost of $500 with my good insurance (so screening every six months) as well as a clinical breast exam from a doctor every six months. That’s only breasts. Someone who is BRCA+ also needs ovarian cancer screening, of which there are no good options, but they usually go with transvaginal ultrasound and CA125 blood test, and clinical exam, every six months. With two appointments every six months for breasts alone, plus one for ovaries twice a year, and follow-ups from mammograms that may require more X-rays, ultrasounds, and biopsies, one appointment certainly runs into the next. It becomes a full-time job. And there is something we call “scan-xiety,” which is worrying about the test before it happens, and after it happens before you get results. Your life becomes about worrying about your breasts. Not so much watching for “if” you will get cancer, but “when.” And all that work for what? Catching it early? BRCA1 cancers are often triple negative, meaning they have no hormone receptors that can be treated with drugs to prevent a recurrence. Catching it early is no guarantee you won’t die from it. We have a saying… that choosing surgery is choosing to have mastectomy without the side of chemo.
As much as others and I think the science is flawed, it is sadly the best we have available. And when you are making decisions about your future, you make the best decision you can with the best information you have.
When I’ve been talking with others about Jolie’s decision, I keep saying, “If it were me, I have no idea what I would do.” After reading Brenda’s description of what monitoring entails, I am leaning more and more towards saying, “Yes, I would lob them off!”
Being a feminist and a student of science can be difficult. On one hand, removing ones breasts despite the hyper-sexualized world we live in is an empowered move. It says, “F*^! you, my life is worth more than saving my breasts. I am more than a body part.” On the other hand, they are body parts and I want science to be past what feels like a medieval procedure. I want science to prevent cancer without us having to remove body parts.
Jolie’s courage to share her story, just as Christina Applegate did previously, will influence other women’s decisions. I also hope that Jolie takes her activism to the cause of breast cancer awareness and prevention. Applegate has a foundation that supports women and assists them in obtaining MRIs. Breast Cancer Action was an early critic of Susan G. Komen for the Cure and asks us to “Think Before You Pink.” I hope she lends her voice to those of us discussing the pending Supreme Court case that will rule on whether or not a company can be the sole provider of a test that asks women to make life-or-death decisions.
Lastly, I hope we get to see her toting around her Amazon grandchildren at movie premieres in the far future. Because you know they are going to be as kick ass as she is.
Contributor Veronica Arreola writes the blog Viva la Feminista, where she tries to navigate and understand the intersection between feminism, motherhood and her Latinadad. You can follow her on Twitter @veronicaeye