Did we need to know about Angelina’s mastectomy?

Last Updated: Fri, May 17, 2013 11:45 hrs

Not since Seth MacFarlane’s Boob Song at the Oscars have breasts trended for so long on Twitter. But, on Tuesday, Angelina Jolie revealed that she had chosen to have a double mastectomy. Her article for The New York Times, since reproduced in multiple publications across the world, has made her something of a hero for women’s health. However, despite everyone’s pretence of dissociating her decision from her celebrity-dom, one wonders whether it may not spark off a trend.

I’m not suggesting that women with a history of breast cancer in the family will start lining up to get their breasts removed, because Angelina did it. But, one assumes that celebrities who can afford the best treatment, and whose bodies are among their most prized assets, make such decisions only when there is no other option.

According to several doctors I spoke to, this is not the case. One, asking not to be named, said Angelina may have jumped the gun, and made a “very stupid decision”.

To begin with, the test to detect the BRCA 1 or BRCA 2 gene mutation is not widely available in India. Even in the rest of the world, the test is not entirely reliable.

Secondly, the fact that one does not carry the faulty gene does not mean that the cancer may not develop later in one’s life.

Thirdly, even when cancer itself is detected, the medical priority is to save the organ. It is possible, with the technology available today, to remove a tumour in its entirety, when detected early enough, while saving the breast tissue.

The test in India costs at least Rs 50,000, and unlike in the West, it is not covered by most medical insurance policies. While the surgery that Angelina Jolie describes is not usually life-threatening, it is possible for complications to arise.

In her article, Jolie speaks in detail of the procedure to save her nipples, and put in silicone implants, so that there will be no external evidence of the fact that she has lost her breasts. However, this surgery is so expensive that few people who are not movie stars can afford it, anywhere in the world.

Most women who have mastectomies either opt for an external prosthesis, or for counselling to deal with the change in their bodies, and therefore self-image.

With regular tests and constant monitoring, it is possible to detect cancer early, and take less drastic steps to deal with it.

Of course, Angelina Jolie has every right to choose what she wants to do with her body. But one wonders whether she really needed to generate the sort of publicity she has. Is there enough medical proof to certify that what she did was the right thing to do, that it was even the safest thing to do? Should she be hailed as a hero and a mascot for health for writing about what she went through?

Even if other women choose to have a preventive mastectomy, and feel the need to reach out for inspiration, chances are that their stories will be dramatically different from Angelina’s, and not just because she can afford the sort of cosmetic alternatives that they cannot.

With social media armed to make a debate out of every news item, Jolie’s article had its share of defenders, trolls, and readers who didn’t care. I may have belonged somewhere between the ‘reader who didn’t care’ and ‘troll’ category (come on, which humour writer can resist a celebrity boob joke?), until I read the follow-up articles the news generated.

Some speak of other women who have had the same surgery, earlier. Others speak of the awareness Angelina Jolie has raised about the gene mutation test. Most feature interviews with doctors and experts who advise caution, but are wary of saying anything that may be seen as putting down Angelina.

Over the last few years, celebrities have chosen to come out in the open about traumatic events in their lives, as well as about medical disorders, both psychiatric and physical. Perhaps it makes their fans – and victims of the same condition or situation – feel more secure, less disconnected, knowing that someone famous was bullied, or sexually abused, or suffers from depression or a disease, knowing that someone famous has conquered it all to become famous, or has dealt with it under the public eye.

Though I don’t think we needed to know about Angelina Jolie’s mastectomy, she had a right to speak about it.

However, I do have issues with her becoming the poster-girl for cancer awareness. Women should know that what she did is not the only solution, and may not even be a lasting solution. Let’s not forget that she didn’t even have cancer at the time she made her decision.

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