Furthering awareness of breast cancer and breast reconstruction

The most prominent news in breast cancer today is the recent announcement by actress Angelina Jolie of her opting for bilateral prophylactic mastectomy (removal of both breasts) due to her high risk of developing breast cancer in the future, although she does not have breast cancer now.  It began with her mother's recent fight with ovarian cancer, which then led to testing for a gene linked to both of these cancers.  It ended up that she does have the BRCA1 gene, which poses approximately between 65-87% risk for developing breast cancer throughout the afflicted person's lifetime.  In addition, there is also an association with ovarian cancer. 

With this gene, it is recommended to have both breasts and ovaries surgically removed.  Angelina Jolie did undergo bilateral mastectomy, followed by immediate implant-based breast reconstruction.  She relates having a nipple-sparing mastectomy, in which the nipples are spared, as long as there was no diagnosed cancer in the ductal tissue when tested.  Breast reconstruction is certainly an option for any woman after a mastectomy.  She said that she hoped that other women would find encouragement from her story.

"I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer," Jolie said in the Times article. "It is my hope that they, too, will be able to get gene tested, and that if they have a high risk they, too, will know that they have strong options."

"I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer. It is my hope that they, too, will be able to get gene tested, and that if they have a high risk they, too, will know that they have strong options."

Here is the link to her New York Times op-ed piece:
http://www.nytimes.com/2013/05/14/opinion/my-medical-choice.html?_r=0

I would hope that this announcement by such a prominent figure helps even more in the fight against breast cancer, not only in awareness and options, but in research, funding, and eventual cure of this disease. 

Increase in breast reconstruction

A recent report which looked at the effect of legislation on breast reconstruction has recently been published.  There is a dramatic increase in those people who have not only been informed of their option for breast reconstruction after a mastectomy, but also in the number of people who underwent the procedure.  This does show the effect of legislation such as the Women's Health and Cancer Rights Act of 1998.

Between 2000 and 2009, >168,000 women in the database of this study underwent mastectomy and 35,000 of them had breast reconstruction immediately following their cancer treatment.  Roughly 13% in 2000 had breast reconstruction as opposed to 36% in 2009.  While these with health insurance still had high numbers, the greatest increase in reconstruction rates over this decade was among women covered by MediCare and MedicAid.  In 2000, just ~5% of women on MedicAid had breast reconstruction performed, whereas 20% had it done in 2009 - approximately a 4-fold increase!  Along similar lines, those on MediCare also tripled from 4.3 to 12.3% during the same time span.  Women with private insurance more than doubled their rate of reconstructions from 22.1-57.1%.

The option and knowledge of breast reconstruction is certainly rising as shown.  Strives still need to be made to educate the physician and patient alike, about this option and the effect that it has on women both mentally and psychologically, along with the physical aspects.