Christina Applegate Seeks Early Detection for Breast Cancer
Inspired by her own battle with cancer, the actress fights to help young women at high risk for the disease.
Breast Cancer Early Detection
Another goal for RAW is support for genetic testing and counseling for women who may have genetic mutations that raise their risk for breast cancer, such as the BRCA1 mutation Applegate has. "Genetic testing and counseling can be very expensive and are often not covered by insurance, but having that information can radically change how you're treated. Finding out I was BRCA-positive made my choice about treatment very different," says Applegate, who had a bilateral mastectomy (both breasts removed).
After the cancer was initially diagnosed, Applegate first had two lumpectomies. Only after those surgeries did she receive the results of her genetic testing. "I went in and talked to my doctor, and at first I was very against the idea of mastectomy. I cried and said there's no way in hell I'm doing this. Then it just hit me: I had a chance of recurrence that was way above 50%. I didn't want to live with that fear for the rest of my life, so I came to terms with it, and we went ahead and decided to take both off."
Applegate's decision was an understandable one, says Eric Winer, MD, director of the Breast Oncology Center and chief of the division of women's cancers at the Dana-Farber Cancer Institute in Boston. "We know that women who have a mutation and have a first breast cancer are at substantially increased risk of cancer in the other breast. She could have chosen other options, but I think for a woman in her situation, this is the approach that would give her the least likelihood of a subsequent problem." On the other hand, women who have "sporadic" cancers -- those that are not linked to a known cancer-causing mutation -- do not appear to reap any long-term survival benefit from "prophylactic" double mastectomies, Winer says.
Risk Factors for Early Breast Cancer
The doctor who helped Applegate decide on her mastectomy was Philomena McAndrew, MD, a medical oncologist with the Tower Hematology/Oncology Group in Los Angeles and associate medical director for breast oncology at the Saul and Joyce Brandman Breast Center at Cedars-Sinai. She says all young women --not just those at high risk, like Applegate -- need to be vigilant about breast cancer.
"Young women have to know they're not somehow protected from getting breast cancer until they're older," McAndrew says. "Christina, of course, faced a higher risk because of her family history [and genetic mutation], but even among women with no family history, we're seeing increasing risk of breast cancer in younger populations.
"There are a variety of reasons for this, including later first pregnancies, an increase in obesity, environmental exposures to things like hormones, and other factors -- things that have stimulated the proliferation of breast tissue more today than 100 years ago."