ABSTRACT

On May 14, 2013, an op-ed appeared in The New York Times detailing Angelina Jolie’s “medical choice” to have her breasts removed via a double mastectomy. She explained that she carries “a ‘faulty’ gene, BRCA1, which sharply increases [her] risk of developing breast cancer and ovarian cancer” (Jolie, 2013). She told her readers that her “doctors estimated [she] had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer, although the risk is different in the case of each woman” (Jolie, 2013). For this reason, because her mother and aunt both died of breast cancer, and her own desire to mother her children, she decided on the radical course of treatment. I say radical because as she herself noted, “only a fraction of breast cancers result from an inherited gene mutation. Those with a defect in BRCA1 have a 65 percent risk of getting it, on average” (Jolie, 2013). Yet these numbers may be misleading; according to the National Cancer Institute at the National Institutes of Health in the United States:

Risk estimates that are based on families with many affected members may not accurately reflect the levels of risk for BRCA1 and BRCA2 mutation carriers in the general population. In addition, no data are available from long-term studies of the general population comparing cancer risk in women who have harmful BRCA1 or BRCA2 mutations with women who do not have such mutations. Therefore, the percentages given are estimates that may change as more data become available. (Landsman, 2013; National Cancer Institute, 2014)

Jolie’s experience reflects a wider medical discourse that deals with shifting definitions of health, increasing agency of patients in determining their own role in health and how to prevent disease, and the ways that medical knowledge is translated from experts to the community. Understanding how to critique these issues in the contemporary context is important, but to do so effectively, we need to understand where ideas about, in this case, cancer treatment, the body, and cosmetic surgery, come from. Of course, we can make the same argument about really any issue we encounter today: everything has a history.