Don't Blame Angelina Jolie; It Should be Called the Sandra Lee Syndrome

mastectomy via shutterstock mastectomy via shutterstock

The fear of breast cancer has more women scrambling to have prophylactic mastectomies. This extreme, and possibly very unnecessary mutilating act, is being embraced by celebrities and their followers, most of whom lack the medical credibility to be advising sea monkeys much less the general public.

However, the distinction must be made between individuals who have prophylactic mastectomies for valid reasons, versus those who are succumbing to fear mongering. An oft-cited example is Angelina Jolie, who underwent mastectomies and bilateral removal of her ovaries and fallopian tubes, because she carries the BRCA mutation, which predisposes women toward developing breast and ovarian cancer. In Ms. Jolie s case, her mother died of breast cancer and she has had other family members succumb to the disease. Her reason was valid.

But because of her fame, some confused members of the media refer to hastened prophylactic mastectomies without reason as the Angelina Jolie Syndrome. This is wrong and unfair to her. Given the statistical likelihood that she would have developed a form of breast cancer that would be difficult to treat, she made a serious decision to circumvent the likelihood of a cancer diagnosis. If a woman has one of the high-risk BRCA mutations, family history becomes a non-factor, the markedly-elevated cancer risk warrants a focused discussion about surgery like that performed on Ms. Jolie.

What the syndrome is instead referring to is the desire of society to promote extreme healthfulness, and stigmatize anything that does not fit the mold of what is considered to be aesthetically pleasing -- even if it means butchering oneself to do so. Ms. Jolie is not the person who did that, but a celebrity who did is named Sandra Lee.

As Dr. Gil Ross wrote, Ms. Lee was diagnosed with a form of pre-invasive lesion known as ductal carcinoma in situ (DCIS) that is successfully treated with breast-conserving surgery and has a 98 percent curative rate. Yet, she unnecessarily opted for a double mastectomy.

Ms. Lee, using her celebrity status on the Food Network and as the domestic partner of New York governor Andrew Cuomo, now calls for more mammograms and defies all medical experts by encouraging women to demand screening mammograms in their 20s and 30s.

One reason younger women should not have them is the presence of denser, more fibro-fatty breast tissue compared to older women, which can complicate the clinical distinction between normal tissue and cancer.

Unfortunately, for Ms. Lee, she ended up suffering post-operative complications from her procedure, and that is a very real possibility for anyone undergoing such an invasive surgery. Needless surgery opens the patient to all forms of hospital-acquired infections and a slew of other complications.

It is unfortunate when a colloquial term for dangerous behavior gets attached to someone being responsible about their health, such as Ms. Jolie. The more appropriate term for someone who adds to unfounded fears, possibly leading to poorer health outcomes, would be the Sandra Lee syndrome.