Vim & Vigor - Winter 2019 - UVA - 27

CONSIDERING
A PREVENTIVE
MASTECTOMY?

Angelina Jolie may be the most famous woman known to have inherited
a higher risk for breast cancer. Jolie used her fame to spread awareness
about taking steps to prevent cancer by having both breasts removed.
Today, nearly 1 in 5 women with cancer in a single breast opt to have
both breasts removed, despite the fact that there is no evidence that it
reduces mortality and increases survival.
"This is a largely patientdriven phenomenon that hapWEBSITE
pened after Angelina Jolie went
public with her diagnosis and
surgical options in 2013," says
UVA Health breast surgeon
Lynn Dengel, MD. This is an
ever-present topic at annual
meetings of the American
Society of Breast Surgeons,
Research shows that patients who
which in 2016 endorsed a conare better informed have better
sensus statement discouraging
outcomes. Learn more about a
removing both breasts for
UVA oncology nurse's efforts to
women of average cancer risk.
aid women facing breast cancer.
Crystal Chu, a UVA oncology
Visit uvahealth.com/angelina.
nurse and doctoral student,
is hopeful that a decision aid
she developed and is testing
in a pilot study will decrease
the number of women having
the healthy breast removed along with the cancerous one, a procedure
called a contralateral prophylactic mastectomy (CPM). CPM is "a much
more complicated surgery," Chu says, "and poses a greater medical risk, a
greater likelihood of pain, possibility of infection, a longer recovery time,
and, by virtue of that, may require a longer wait time to administer subsequent chemotherapy and radiation treatments to fight the cancer in the
diseased breast." Chu's decision aid, delivered on an iPad by a nurse, aims
to better inform these patients of the full spectrum of risks and benefits.

ILLUSTRATIONS BY DANTE TERZIGNI

Before You
Make a Decision,
Read This First

being mutation carriers to lower their
risk, and, regardless, everyone should
follow the American Cancer Society's
guidelines for cancer prevention," she
says. That's because anyone can get
cancer, and these guidelines "are also
recommendations that overlap with prevention of other chronic diseases."
In addition to exercising, avoiding
smoking and limiting alcohol, recommendations include having regular
cancer screenings, getting vaccinated
for HPV (or human papillomavirus,
a cause of cancer), eating a balanced,
mostly plant-based diet and maintaining a healthy weight. Gaudet also

recommends that women attempt to
breastfeed after having children, which
helps lower the risk of breast cancer
and comes with other health benefits
for mom and baby.

GET SCREENED
WITH CARE

If you look at your family's medical
history and decide genetic testing is
right for you, it is important to opt

for a true genetic counselor-one who
works with a hospital, doctor's office
or genetic counseling clinic-rather
than relying on an online service, the
National Cancer Institute recommends.
For starters, a genetic counselor can
help you accurately interpret your
test results and explain what those
results might mean for the rest of your
family-your children, siblings
or parents. ■
WIN TE R 2019

27
http://www.uvahealth.com/angelina
Vim & Vigor - Winter 2019 - UVA

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