Christina Applegate had a double mastectomy, and is using her opportunity to educating the public about breast cancer awareness.  I applaud her…  what a sensitive, personal decision to have to make– and the fact that she is doing it in the public eye and keeping her chin up is quite amazing.

While I am SO glad her cancer was caught at a treatable stage, it doesn’t make the treatment decision any easier.  During medical school, I saw quite a few women grapple with the choice of having a mastectomy or double mastectomy, and it is truly a scary proposition, with no definitive answer.  It’s a very personal decision, to be considered carefully by the woman and her support network, including a breast surgeon, an oncologist, a geneticist, or whatever physicians she chooses to recruit to support her in her treatment plan.

Why do some women opt to have a prophylactic double mastectomy?  One of the major considerations may be the presence of a mutated breast cancer gene (BRCA 1/2).

For women who don’t have an abnormal BRCA1 or BRCA2 gene, the risk of developing a new breast cancer in the other breast is about 1% a year. After 10 years, this risk is about 10%. For women who have an abnormal BRCA1 or BRCA2 gene, the risk of developing a new breast cancer in the other breast is higher. Their risk can be 3 to 4% per year (30% to 40% over 10 years).  (www.breastcancer.org)

But these are just the statistics– there are many other factors, including quality of life, other risk factors that may be present, and the patient’s tolerance for uncertainty.

Regardless of treatment decisions, breast cancer survivors have gone through a life-changing process, filled with a lot of emotional upheaval, and are definitely heroes for all they have endured.

Frankly, Christina’s perspective is admirable:  she told the interviewer, “Sometimes, you know, I cry, and sometimes I scream. And I get really angry. And I get really upset, you know, into wallowing in self-pity sometimes. And I think it’s all part of the healing.”  Part of that process includes seeing the humor in things– “I’m going to have cute boobs ’til I’m 90,” she claimed.   Good for you, Christina!  Good luck with the reconstruction, and flaunt those cute boobs.  You totally deserve it!