Christina Applegate's Mastectomy: FAQ
Breast Cancer Survivor Christina Applegate Opts for Preventive Double Mastectomy and Breast Reconstructive Surgery
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Did Applegate make a good choice? continued...
"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."
Does double mastectomy totally eliminate her risk?
Almost, but not quite; there's an estimated 5% chance of breast cancer after
such a procedure, notes Neil Friedman, MD, FACS, medical director of the
Hoffberger Breast Center at Mercy Medical Center in Baltimore.
He explains that there's no clear line where breast tissue ends.
"When you're in the operating room, it's not like you can look and say, 'All
that yellow tissue is breast tissue and all that white tissue is fat.' So you
try and take all the tissue out that you can, but you can leave isolated breast
cells underneath the skin. Everybody does; there's not
a surgeon in the world that can do that and remove all of the cells. That's why
there is a small risk of having a breast cancer develop in one of those cells
-- pretty uncommon, but it can happen," says Friedman.
Friedman says that immediate reconstruction -- starting the process at the
time of the mastectomy -- "is something that should be offered to all
"I offer it to all of my patients and if I think there's a reason why they
shouldn't get it from a medical perspective, then I [explain why] I think it's
advisable to delay the reconstruction. But they should at least have that
conversation with their surgeons," says Friedman, adding that breast
reconstruction is not an insurance issue, because it "must be paid for by
federal law," regardless of the patient's age.