Before getting her preventive (prophylactic) double mastectomy three and
half weeks ago, Applegate had two lumpectomies -- and only had cancer in one
breast, according to Good Morning America -- and took a gene test that
showed that she had the BRCA1 gene mutation, which makes breast cancer and ovarian cancer more likely.
Applegate called her mastectomy decision "tough" but the "most logical"
possibility for her. She said she based her choice on her family history -- her
mother has had breast cancer and cervical cancer -- and her
Is Applegate's approach to breast cancer one that would work for other
breast cancer patients? And what will the reconstruction process -- for
Applegate and for other women -- be like?
WebMD talked with four doctors -- and with a breast cancer survivor who made
some of the same choices that Applegate did -- about preventive mastectomy and
breast reconstructive surgery. None of the doctors who talked to WebMD are
"I think she did the absolute right thing, and she did it the right way,"
says Jay Brooks, MD, FACP, chief of hematology/oncology and chief of staff at
the Ochsner Health System in Baton Rouge, La.
"She underwent lumpectomy and then, when she got the information back from
the genetic testing, she was able to have a little time to discern what this
all meant and then she went forward to have the prophylactic mastectomies,
which are clearly the best treatment to reduce her risk of ever developing
breast cancer [again] by at least 90%," says Brooks.
"I think that's a very reasonable approach," says Brooks. "It may not be
right for every patient, but I think especially if you have this genetic
mutation -- it's such a highly active mutation in terms of increasing the risk
of breast cancer -- that it's certainly something that I would recommend to one
of my family members or to my patients, and I do," says Brooks, noting that
only about 5% to 7% of breast cancer patients have cases similar to
"Because her risk of an additional breast cancer is extremely high, in the
range of one in two, why take a chance?" asks Eli Avisar, MD, breast cancer
surgeon at the Sylvester Comprehensive Cancer Center at the University of Miami
Miller School of Medicine.
Gisella Alvarez, RNC, is a nurse at Mercy Medical Center. Two years ago, at
age 44, Alvarez learned she had stage I breast cancer in one breast. She
decided to have both breasts removed and get breast reconstruction. Her case
wasn't exactly like Applegate's -- Alvarez had an elderly aunt who had had
breast cancer but she hadn't had the BRCA gene test -- but she took a similar
Alvarez says Applegate's decision was "brave" and "smart because life is too
short. It's not worth living your life worrying every six months when you have
to go back for tests and more tests -- and hoping that it's not going to come
back. With this way, you really increase your chances of not having to worry
about it again and live your life."