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I recently saw a re-run of an interview on Oprah with Christina Applegate, and she explained why she chose a double mastectomy for the treatment and prevention of breast cancer. I cannot share the Oprah video, but above is another good segment discussing this topic.If you want to see a text version of her interview, go here to Oprah’s website.
Christina Applegate and Sheryl Crow both had breast cancer, but they chose a different surgical treatment for their disease. Christina chose double mastectomy with breast reconstructive surgery while Sheryl Crow chose a lumpectomy only. See my blogs on Sheryl Crow at http://mycanceradvisor.com/2009/04/20/121/ and http://mycanceradvisor.com/2009/06/28/cheryl-crow-talks-with-her-surgeon-about-her-experience-with-breast-cancer/.
As Christina Applegate discussed on the Oprah Winfrey Show, she was very satisfied with her choice and with the results. Likewise, when Sheryl Crow discussed her results on YouTube (with her surgeon no less) she was very satisfied with the symmetry of her breast after surgery. These two stars illustrate how different choices can lead to appropriate results in individual breast cancer patients. Sometimes the size or multiple areas of breast cancer will medically necessitate a mastectomy. In other circumstances a woman may choose a single mastectomy (or a double mastectomy) out of concern for recurrences in the breast at a later time. In effect they are choosing a form of cancer prevention through a mastectomy. On the other hand, a lumpectomy (almost always with breast irradiation) is another equally good option for other women who want to keep their breasts in tact and understand that there is a possibility (of 8-10%) that their breast cancer will return in one or the other breast. Women who have a strong family history, who have had multiple biopsies, who have difficult breasts to follow on X-ray, or who have inherited susceptibility genes (BRAC-1/2), or certain types of breast cancer (especially Lobular Carcinoma) are at increased risk for having a second breast cancer at a later time. If a woman chooses this option, then careful follow-up with screening and chemo prevention (with hormone therapy) should be their treatment plan.
For Christina Applegate, she won’t ever have to have a mammogram again or worry about the prospects of recurring breast cancer or of dying from it. Both choices are medically appropriate and must be tailored to the “risk avoidance” philosophy of the patient and their own perception about how the surgical choice affects their quality of life.
She has formed a Foundation that helps women at high risk for breast cancer that do not have adequate insurance or financial capability to cover essential breast screenings get financial help. See her website at http://www.rightactionforwomen.org/.
For more information about this subject see my previous blogs on Surgical Treatment Options for Breast Cancer and In the Operating Room: Breast Reconstruction. For detailed information about breast cancer staging and treatment go to our companion website, patientresource.net.