裘莉醫師：割乳後 罹乳癌機率從87%降至5%
2013年05月14日16:04
現年37歲美國好萊塢女星安潔莉娜裘莉（Angelina Jolie），今日在《紐約時報》投書表示，為了降低罹患乳癌和卵巢癌的風險，進行了割除雙乳的手術。而裘莉也在文中提到，她的主治醫師向她表示，割乳後罹患乳癌的機率為從87%，降至5%。
另外，裘莉也提到，整個手術療程為時3個月，分為3階段進行。其中有一個手術階段是將引流管插入乳房，她直呼：「好像在拍科幻片一樣。」裘莉也說，手術最後一個階段就是將填充物植入胸部，她表示接下來需要花幾年時間來做復健，「但相信結果會非常美好」。
切除雙乳防癌／安潔莉娜裘莉：無損我的女性特質
2013-05-14 Web only 作者：吳凱琳編譯
美國女星安潔莉娜‧裘莉（Angelina Jolie ）14日投書《紐約時報》，表示為了預防乳癌的發生，進行預防性手術，切除乳房。
一切都源自於她母親早逝帶給她的傷痛。
她母親因罹患癌症，年僅56歲便離開人世，「我的孩子們常問我，我會不會也像自己的母親那樣早地離開他們，我總是告訴他們別擔心，」但事實上，安潔莉娜‧裘莉心裡明白，經過醫學檢查，證實她體內帶有BRCA1 基因。女性若遺傳到這種基因，罹患乳癌和卵巢癌的機率將大增。安潔莉娜‧裘莉的醫師預估，她罹患乳癌和卵巢癌的機率分別為87％與50％。
於是，她做出了常人難以想像的重大決定：切除雙乳，預防乳癌發生。
整體療程開始於今年2月2日，歷經乳房組織切除與義乳重建等手術，直到4月底，總計9星期的療程全部結束。安潔莉娜‧裘莉形容，整個過程就像是科幻電影的場景般，休息幾天之後，便可立即恢復正常生活。
更幸運的是，她的乳癌病發機率從87％驟降為5％。她也沒有因為乳房切除手術而感到任何的不適應，「我並沒有因此感覺自己不再像是女人，我反而覺得自己做了很勇敢的決定，而這個決定絲毫未減損我的女性特質。」
在文章中，她特別感謝人生的伴侶布萊德‧彼特（Brad Pitt ），「在經歷手術過程的每分每秒，他都一直陪在我身旁。我們倆都認為這是對我們的家庭最正確的決定，這個決定也讓我們彼此更為親密。」
文章最後她特別提到，之所以決定公開自己的隱私，目的是期望幫助更多女性選擇正確的醫療方式，遠離癌症威脅。根據世界衛生組織統計，每年死於乳癌的女性高達45.8萬人，或許她的經驗可以提供參考。不過，究竟預防性手術是否是治療癌症的最恰當方式，恐怕有待醫療專業的評估。（吳凱琳編譯）
安潔莉娜‧裘莉投書《紐約時報》「My Medical Choice」全文
My Medical Choice
By ANGELINA JOLIE
Published: May 14, 2013
MY MOTHER fought cancer for almost a decade and died at 56. She held out long enough to meet the first of her grandchildren and to hold them in her arms. But my other children will never have the chance to know her and experience how loving and gracious she was.
We often speak of “Mommy’s mommy,” and I find myself trying to explain the illness that took her away from us. They have asked if the same could happen to me. I have always told them not to worry, but the truth is I carry a “faulty” gene, BRCA1, which sharply increases my risk of developing breast cancer and ovarian cancer.
My doctors estimated that I had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer, although the risk is different in the case of each woman.
Only a fraction of breast cancers result from an inherited gene mutation. Those with a defect in BRCA1 have a 65 percent risk of getting it, on average.
Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much I could. I made a decision to have a preventive double mastectomy. I started with the breasts, as my risk of breast cancer is higher than my risk of ovarian cancer, and the surgery is more complex.
On April 27, I finished the three months of medical procedures that the mastectomies involved. During that time I have been able to keep this private and to carry on with my work.
But I am writing about it now because I hope that other women can benefit from my experience. Cancer is still a word that strikes fear into people’s hearts, producing a deep sense of powerlessness. But today it is possible to find out through a blood test whether you are highly susceptible to breast and ovarian cancer, and then take action.
My own process began on Feb. 2 with a procedure known as a “nipple delay,” which rules out disease in the breast ducts behind the nipple and draws extra blood flow to the area. This causes some pain and a lot of bruising, but it increases the chance of saving the nipple.
Two weeks later I had the major surgery, where the breast tissue is removed and temporary fillers are put in place. The operation can take eight hours. You wake up with drain tubes and expanders in your breasts. It does feel like a scene out of a science-fiction film. But days after surgery you can be back to a normal life.
Nine weeks later, the final surgery is completed with the reconstruction of the breasts with an implant. There have been many advances in this procedure in the last few years, and the results can be beautiful.
I wanted to write this to tell other women that the decision to have a mastectomy was not easy. But it is one I am very happy that I made. My chances of developing breast cancer have dropped from 87 percent to under 5 percent. I can tell my children that they don’t need to fear they will lose me to breast cancer.
It is reassuring that they see nothing that makes them uncomfortable. They can see my small scars and that’s it. Everything else is just Mommy, the same as she always was. And they know that I love them and will do anything to be with them as long as I can. On a personal note, I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity.
I am fortunate to have a partner, Brad Pitt, who is so loving and supportive. So to anyone who has a wife or girlfriend going through this, know that you are a very important part of the transition. Brad was at the Pink Lotus Breast Center, where I was treated, for every minute of the surgeries. We managed to find moments to laugh together. We knew this was the right thing to do for our family and that it would bring us closer. And it has.
For any woman reading this, I hope it helps you to know you have options. I want to encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices.
I acknowledge that there are many wonderful holistic doctors working on alternatives to surgery. My own regimen will be posted in due course on the Web site of the Pink Lotus Breast Center. I hope that this will be helpful to other women.
Breast cancer alone kills some 458,000 people each year, according to the World Health Organization, mainly in low- and middle-income countries. It has got to be a priority to ensure that more women can access gene testing and lifesaving preventive treatment, whatever their means and background, wherever they live. The cost of testing for BRCA1 and BRCA2, at more than $3,000 in the United States, remains an obstacle for many women.
I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer. It is my hope that they, too, will be able to get gene tested, and that if they have a high risk they, too, will know that they have strong options.
Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of.
Angelina Jolie is an actress and director.
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