Angelina Jolie's announcement Tuesday that she underwent a double mastectomy to reduce her chance of developing breast cancer is drawing attention to a decision that everyday women have weighed.
The actress penned an op-ed for the New York Times, explaining she carries an inherited gene mutation — BRCA1 — that increases her risk for breast and ovarian cancer. The surgery to remove her breasts reduced her chance of developing breast cancer to less than 5 percent from 87 percent, doctors told her.
"I can tell my children that they don't need to fear they will lose me to breast cancer," Jolie wrote.
Dr. Sasmita Misra, medical director of the breast center at Franciscan St. Margaret Health hospitals in Hammond and Dyer, thinks Jolie's announcement will have a positive impact on women facing a similar health circumstance.
Her announcement shows cancer can affect anyone, no matter how much fame and money a person has, Misra said.
"Every time that you are looking into cases of breast cancer, especially where she had the BRCA1 gene, you have to take a lot of things into consideration," Misra said. "Given her risk was high ... I think it was a smart move for her."
Jolie's mother, south suburban native Marcheline Bertrand, died at age 56 in 2007 after battling cancer.
Familial relation is one of the factors considered before genetic testing is done.
"We don't test for every patient, and each patient is unique," Misra said. "There has to be reasons why."
Average women face about an 8 percent chance of developing breast cancer.
"It jumps to 60 percent with the gene mutation," Misra said.
Having a mutation in BRCA1 or BRCA2 does not guarantee a person will develop a malignancy, but carrying that mutation increases the risks of developing breast or ovarian cancer, Indiana University Northwest geneticist Dr. Janice Zunich previously said.
“We all have BRCA1 and BRCA2,” she has said. “If you find a mutation, it does not mean you have a 100 percent chance you will get cancer. You could carry a mutation and never get cancer.”
The genes are there to repair defects in DNA. If they are mutated, they do not work properly and defects in DNA slip through. Defects may go on with no problem, or they may lead to cancer, Zunich has said.
Doctors consider multiple factors to suspect heredity may play a role. Age of diagnosis, location of the cancer, number of tumors, family history and having a male relative with breast cancer are some of the factors, she has said.
Misra has had patients decide different options after learning they carry the gene mutation. Some have the mastectomy, while others choose to monitor through regular mammograms, MRIs and self exams.
"Each patient is different," she said. "There's not a hard and fast rule."
Dr. Susan Schneider, plastic and reconstructive surgeon with Methodist Physician Group, said the focus of her practice is on breast reconstruction after breast cancer.
"There's always scarring involved with any kind of surgery, but I think the advances are making it where we can make it as close to natural as possible," she said.
She sometimes gets involved early on in the discussion between a patient and physician, contributing her thoughts from a cosmetic standpoint.
"I think sometimes it makes the decision to go ahead a little easier," Schneider said. "I think there's a lot of fear for how they're going to look after this."
Schneider, who has offices in Merrillville and Illinois, said Jolie's announcement was not a big subject of conversation at the office Tuesday.
"I deal with women like this every day," she said.