Radical breast cancer preventive surgery common in Brazil

rita-lee

Brazilian pop star Rita Lee knows what Angelina Jolie is going through; she’s been through it herself. And so have many other Brazilian women:

Actress Angelina Jolie caused a great sensation on Tuesday when she announced that she had undergone a double mastectomy to prevent breast cancer. But the procedure is common in Brazil as well. In 2010, singer Rita Lee had her breasts removed, on the advice of her gynecologist. Her mother had died of cancer, and the risk of developing the disease was very high.

“My gynecologist advised me to have my breasts removed, which didn’t make much difference, since mine were already small,” said the singer, interviewed by Istoé magazine, in September 2010. “I prefer to be without breasts and at peace, rather than still have them and be paranoid,” said Lee, who decided not to have reconstruction surgery.

Plastic surgeon and breast specialist João Carlos Sampaio, director of the Brazilian Institute for Cancer Control, said that he performs at least one preventive or prophylactic surgery a week. According to the specialist, the number of such interventions has grown in recent years, as a result of improved surgical techniques and of early diagnostic procedures.

“I recommend it. The result is the same as a breast enlargement,” Sampaio explained, stressing that the scar would be quite small. Before, the patients would ponder more, with fear of suffering some type of mutilation or for esthetic reasons.

João Carlos Sampaio says that he knows of other cases of famous women, including patients of his, who opted to have their breasts removed. He refused to give names for ethical reasons.

Before recommending a preventive surgery for breast cancer, the doctor performs genetic analyses, a genealogy, and pathologic exams to determine if there are pre-cancerous cells. With results in hand, a patent can decide whether to have her breasts removed, take hormone treatments, or only medical follow-ups.

“It’s not obligatory. It’s one option. I always converse with my patients. It’s very important that she understand the risks and the options. Any choice needs to be conscious,” Sampaio emphasizes. “If she has an 87% risk, it’s almost certain that she will have breast cancer,” he says, speaking of the case of Angelina Jolie.

João Carlos Sampaio has developed, and uses in Brazil, a technique more modern than the one used on Angelina Jolie. The actress’s procedure was performed in two phases: first, removal of the breasts, and second, nine weeks later, reconstruction.

Sampaio’s patients have preventive surgery in just one phase. Instead of using an expander, as in Jolie’s case, for weeks, to create space for silicone prostheses, the surgeon lifts the patient’s muscle partially and inserts a type of screen. Then, he implants silicone prostheses and adjusts the size so that the breasts have a natural appearance.

“I was surprised to read that she used the older technique,” Sampaio says, adding that many doctors in the United States use the technique created in Brazil.

The method developed by the Brazilian specialist was published in the 1990s, and has been refined since then.

“I’ve haven’t been using the expander for nearly 20 years. There is no more need for that type of surgery.”

Angelina Jolie’s mother died of cancer at age 56, after nearly a decade of fighting against the disease. The actress had an 87% chance of developing breast cancer, and a 50% chance of contracting ovarian cancer.

Translation mine.

Like Angelina Jolie, Rita Lee lost her mother to breast cancer. Unlike her, she chose not to have reconstruction, as there wasn’t much to rebuild in the first place. Here she is as a teenager in the late 1960s, with her then boyfriend and his brother, as the wildly popular rock-tropicalist trio, Os Mutantes:

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