Mansplained: Don't Have a Preventative Mastectomy Just 'Cuz Angie Did

Ladies and their favorite celebrities, amiright? If Connie Britton jumped off a bridge, wouldn’t you? If Cate Blanchett ran down Seventh Avenue in a duck suit yelling about the End of Days, hand me my beak!

H. Gilbert Welch, a professor of medicine at the Dartmouth Institute for Health Policy and Clinical Practice and a co-author of Overdiagnosed: Making People Sick in the Pursuit of Health, is worried that perfectly healthy women will undergo preventative mastectomies because Angelina Jolie had one. “I hope I’m positive for the BRCA1 gene!” exclaim all women, everywhere. “Then I can land a guy like Brad Pitt!”

The vast majority of women don’t have BRCA1. They are at average risk for breast cancer. They are not Angelina Jolie. They should not have a preventive mastectomy.

Which is totally legitimate and fine, and also has been studied and confirmed, if Welch just stopped there. He doesn’t. He argues against getting the $3,000 BRCA1 screening test in the first place: your family history of cancer is a good enough indication of how at-risk you are: “Population-wide screening raises complex issues. We would want to know more about how often the test is wrong, particularly how often the test is falsely positive. That’s important because women falsely diagnosed as a mutation carrier might undergo prophylactic mastectomy unnecessarily. Then there are the psychological effects, not only for the patient but also for her siblings and offspring.”

Go figure! That’s why Cath Gilroy, the Manchester woman diagnosed — along with her daughter and sister — with the BRCA2 gene, had to nag her doctors repeatedly for the test. If a person has the financial resources, feels she might be at risk for the gene and wants to take the screening test, there’s absolutely no good reason to refuse her, even if you think she’s being (ugh) “hysterical.”

And this:

A few weeks ago, in a New York Times Magazine piece, Peggy Orenstein related her first instinct when facing breast cancer recurrence: take the other breast too. Her oncologist responded with a simple question: “Would an average woman cut off her breasts?”