What You Should Know About Cancer-Preventing Surgery

Angelina Jolie Pitt revealed that she had preventive surgery to remove her breasts, ovaries, and fallopian tubes, touching on a conversation about cancer risk.

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In a moving New York Times op-ed, Angelina Jolie Pitt revealed that she had preventive surgery to remove her ovaries and fallopian tubes. She announced this two years after she disclosed that she had a preventive double mastectomy in 2013, touching on a national conversation about cancer risk.

Jolie Pitt carries a mutation in the BRCA1 gene that gives her an 87% chance of developing breast cancer and a 50% chance of developing ovarian cancer. She lost her mother, grandmother, and aunt to cancer.

Find out more about preventative cancer surgery including the effects and benefits.

What Is the BRCA1 Gene?

The BReast CAncer gene 1 (BRCA1) and BReast CAncer gene 2 (BRCA2) are genes that everyone has two copies of (one from each parent). These genes produce proteins that help to repair damaged DNA.

But some people inherit harmful variants of these genes and that can lead to an increased risk of developing certain kinds of cancer. The most common of which is breast cancer.

If you have a parent who carries this gene mutation, you have a 50% chance of inheriting the mutation yourself.

What Is Preventative Surgery To Reduce Cancer Risk?

Surgery can be used as a way to prevent certain cancers. Jolie Pitt had a prophylactic mastectomy as well as a prophylactic salpino-oophorectomy.

Preventative Surgery for Breast Cancer

A prophylactic mastectomy is when one or both of the breasts are removed in order to prevent breast cancer. This type of surgery is recommended for people who are at an increased risk for developing breast cancer. This may be because they have a family history or because they have the BRCA1 or BRCA2 gene mutation.

A prophylactic mastectomy can lower the risk of breast cancer by 90% or more. This surgery does not guarantee that you won't get breast cancer, but it does reduce your risk.

Preventative Surgery for Ovarian Cancer

A prophylactic salpingo-oopherectomy involves the removal of both ovaries and fallopian tubes in order to prevent ovarian cancer. This type of surgery is usually recommended for people who are at a high risk of developing ovarian cancer and if they don't wish to become pregnant in the future.

Since women with BRCA1 or BRCA2 mutations are also at increased risk of fallopian tube cancer, experts usually recommend removing both the fallopian tubes with the ovaries.

The risk of ovarian cancer is reduce by 85% to 95% for people who have the BRCA gene mutations and had surgery to remove their ovaries. And the risk for breast cancer for people who had this type of surgery was reduced by 50%.

What Are the Effects of Preventative Surgery?

Both of these surgeries are irreversible so it is important to take into account the effects that may occur post-op. With any surgery, there are risks of bleeding and infection. But each surgery also comes with it's own effects.

Effects of Preventative Surgery for Breast Cancer

If you undergo a prophylactic mastectomy, you may experience psychological effects. This may include anxiety and concerns about your body and how you view your body. You may also experience feeling a lack of femininity.

After a prophylactic mastectomy, there is also a loss in nipple sensation. This may change or reduce sexual arousal.

Effects of Preventative Surgery for Ovarian Cancer

Removing the ovaries puts you into early menopause, if you haven't gone through menopause already. This change in hormones can cause a series of symptoms such as:

  • Hot flashes
  • Memory problems
  • Urinary problems
  • Mood changes
  • Depression and anxiety
  • Vaginal dryness

Not only will ovary removal send you into early menopause, you will also be unable to become pregnant and your risk for osteoporosis and heart disease increases.

To reduce the risk of osteoporosis and heart disease and the symptoms of menopause, a healthcare provider may suggest hormone therapy as treatment.

Though hormone replacement therapy (HRT) has long been controversial due to a link to increased breast cancer risk, some research suggested that it's safe for women with BRCA1 or BRCA2 mutations to take short-term HRT after a preventive oophorectomy as it will not increase the risk of breast cancer.

Are There Other Preventative Treatment Options?

It's important to know that surgery isn't the only option for women who carry a breast cancer gene mutation. Preventive strategies for ovarian and breast cancer may include:

  • Taking birth control pills
  • Getting frequent screenings
  • Quitting smoking (if you smoke)
  • Getting genetic counseling and testing
  • Tubal ligation (when the fallopian tubes are tied, cut, or blocked)
  • Stayiing physically active

Additionally, you may reduce your risk of developing breast cancer if you limit your alcohol intake and choose to breastfeed your children.

Should You Get Preventative Surgery?

You may be wondering if preventative cancer surgery is right for you. You may want to consider preventative surgery if you:

  • Have the BRCA1 or BRCA2 gene mutation
  • Have a strong family history of breast cancer
  • Had radiation therapy to the chest before the age of 30
  • Have had breast cancer before

You should discuss preventative options with a healthcare provider, especially if you meet any of the criteria above.

As for Angelina Jolie Pitt, despite the side effects of the surgery, she said she's at peace with her decision. "I feel feminine, and grounded in the choices I am making for myself and my family," Jolie Pitt wrote. "Regardless of the hormone replacements I'm taking, I am now in menopause. I will not be able to have any more children, and I expect some physical changes. But I feel at ease with whatever will come, not because I am strong but because this is a part of life. It is nothing to be feared."

A Quick Review

Angelina Jolie Pitt made the decision to have surgery to remove her breasts, ovaries, and fallopian tubes because she inherited a mutated BRCA1 gene. After losing her mother, grandmother, and aunt to cancer, she opted to have preventative surgery done to reduce her risk of developing cancer too.

Preventative cancer surgery may not be for everyone. You may want to consider preventative surgery if you have a strong family history of breast cancer or have a mutated BRCA1 or BRCA2 gene. If you think you are at risk for breast cancer, you can discuss preventative treatment options with a healthcare provider.

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Health.com uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. The New York Times. Angelina Jolie Pitt: Diary of a surgery.

  2. The New York Times. My medical choice.

  3. National Cancer Institute. BRCA gene mutations: cancer risk and genetic testing.

  4. American Cancer Society. Preventative surgery to reduce breast cancer risk.

  5. American Cancer Society. Can ovarian cancer be prevented?

  6. National Cancer Institute. Surgery to reduce the risk of breast cancer.

  7. American Cancer Society. Surgery for ovarian cancer.

  8. Office on Women's Health. Menopause symptoms and relief.

  9. Office on Women's Health. Hysterectomy.

  10. Kaunitz AM, Kapoor E, Faubion S. Treatment of women after bilateral salpingo-oophorectomy performed prior to natural menopause. JAMA. 2021;326(14):1429. doi:10.1001/jama.2021.3305

  11. Kotsopoulos J, Gronwald J, Karlan BY, et al. Hormone replacement therapy after oophorectomy and breast cancer risk among brca1 mutation carriers. JAMA Oncol. 2018;4(8):1059. doi:10.1001/jamaoncol.2018.0211

  12. American Cancer Society. Ovarian cancer risk factors.

  13. American Cancer Society. Can I lower my risk of breast cancer?

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