29 October, 2020

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Breast Cancer, Hollywood style

There has been much recognition of Angelina Jolie‘s public revelation that she has had a prophylactic double mastectomy and reconstructive surgery to avoid breast cancer. She says that although the decision was hard, she made the right choice for herself; that she looks good and feels whole, again. As a gorgeous famous woman and sex symbol, her public sharing is seen as a generous move towards destigmatising breast cancer and a gracious concern for women who might face similar dilemmas.

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    In my opinion, the double mastectomy that Angelina Jolie (and others) have been convinced to subject themselves to is a tragedy, and a result of extreme fear-mongering by the medical profession.

    There are a number of factors that are being ignored in the science that attributes breast cancer to a “breast cancer gene”. This includes the fact that if fear of cancer predisposes to cancer, such familial fears (for example a woman fearing breast cancer because her mother, sister or aunt had it) will, according to the statistical approach that is used, be mistakenly attributed to a genetic cause.

    Also, it is well known that X-rays and other ionizing radiation can cause cancer. Since mammograms are X-rays, it is inevitable that repeated mammograms will also lead to some breast cancers (as do repeated chest X-rays).

    When I was a young doctor in the early 1980s, surgeons in Australia routinely did “radical mastectomies” – the whole breast, underlying pectoralis muscles and axillary lymph nodes were removed, causing terrible disfigurement. Though numerous studies showed that such radical surgery provided no advantage over much more limited surgery (“lumpectomy”, or removal of the tumour without removing the rest of the breast) the older surgeons often continued to perform the old “radical mastectomies” they had “always done”.

    It is important that the studies that have resulted in so-called “prophylactic surgery” being advocated be examined more critically than they are.

    Dr Romesh Senewiratne-Alagaratnam

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