Preventive Surgeries and the Angelina Jolie Effect

Angelina Jolie recently announced to the world that, upon her own initiative, she had her ovaries and fallopian tubes removed (the medical term for this procedure is salpingoophrectomy). What is a preventive surgery and who might benefit from it?

It is well known that there are several cases of death caused by cancer in Angelina’s family history, including her mother. This is the reason why Angelina took a special genetic test to determine whether she is also at risk of developing cancer. Her test results showed that she was a carrier of a BRCA1 gene mutation, which meant that there was at a high of developing breast or ovarian cancer.

In 2012, Angelina went through a double preventive mastectomy and came out to the world with her story in order to raise awareness. For the last three years, mammary surgeons have unanimously been saying that the number of patients asking for a radical surgery instead of an organ-saving procedure has significantly increased. The doctors named this phenomenon “the Angelina Effect”. Today, gynecological surgeons fear that the Angelina Effect might take a new form in unnecessary ovaries and fallopian tubes removal, instead of a more conservative treatment approach.

What Is Preventive Surgery?

During a preventive surgery, the surgeon removes a tissue that is free from malignant cells due to the high risk that of future cancer evolvement. In most cases, preventive surgeries are performed to remove the breasts or the ovaries (and sometimes with the fallopian tubes). In some cases, when there is a high risk of colorectal cancer, a preventive colectomy may be recommended.

What Is BRCA Gene Mutation?

A mutation of the BRCA gene can occur in the BRCA1 or BRCA2 genes.

BRCA1 and BRCA2 are tumor-suppressing genes. The protein that these genes are responsible for prevents malignization of healthy cells, usually in the breasts and ovaries. A mutation in these genes causes Hereditary Breast-Ovarian Cancer Syndrome (HBOS) and puts its carrier in a high risk of developing these types of cancer.

There are hundreds of possible mutations in the BRCA and the exact nature of the connection of these genes to the breast and ovaries cancer is unknown. The probability of inheriting the mutation from one of the parents is 50% (the mutation can be inherited by both sons and daughters), which is what makes it so important to be tested and receive recommendations regarding follow-up. Nonetheless, it is also important to understand that doctors do not always recommend preventive surgery, and sometimes close and constant follow-up is enough to guarantee an early cancer detection, and timely surgery.

Oncological Surgery at Herzliya Medical Center

HMC’s oncological surgeons perform all sorts of surgeries to remove different types of tumors. Our cancer center offers surgical treatment for breast, colorectal, gynecological and other types of cancer. We do our best to perform organ-saving procedures and to preserve patients’ fertility.