It finally came down to genetics, a certainty of lifetime tests, and her family history.
Actress Christina Applegate went public with her decision to have a double mastectomy after being diagnosed with early-stage breast cancer in one of her breasts. (The other was cancer-free.) Many people questioned her choice, wondering if she did it in a state of panic without exploring other treatment options first.
Nothing could be further from the truth.
Applegate, a very sharp lady in real life and not really like the character she played for years on Married With Children certainly knew the score.
She was faced with several major problems in her diagnosis, and none of them were conducive to 'other treatment options'.
Her mother is a cancer survivor, not once but twice, for breast and cervical cancer. In other words, Applegate has a family history, and it's likely she saw her mother take the tests and treatments.
Applegate had genetic testing done before the operation and found out she carried the BRCA-1 gene, which can pre-dispose a woman to breast cancer, and makes her a greater risk under what's called the 'Gail Model'. This determines a woman's risk based on factors such as her current age, the age when she began menstruation, age when first giving birth, the family history of breast cancer, and race, among other things. Applegate would have fallen into the 20% or greater risk group here, which is not a good place to be for the rest of your life.
Because of the BRCA-1 gene and the family history alone, if Applegate had chosen less invasive options, she would have also signed up for a lifetime of twice-a-year MRI's and other tests. Often these tests come back false-positive, and the woman has to worry for a while whether or not she has developed the disease, until doctors can verify whether the test is actually positive or not.
Since Applegate is young and without children, she also has what doctors call 'dense' breasts. This means mammograms can be difficult to read sometimes. She would have had to endure MRI's about every six months for the rest of her life.
This procedure forces a woman to lie on her stomach inside a noisy machine to obtain the image. In addition, doctors inject you with a solution to 'increase contrast' in the final image. There is a risk of renal insufficiency and kidney damage from the solution. And after all of that, there are always the infamous false-positives where a woman has to sweat it out and wait for confirmation.
Faced with these things, and the fact that her Gail Model was so poor, Applegate took charge of her own life and ended the problem with the most radical operation possible - but one that assured her of a 97% chance of never having the disease return.
Now she fully intends to get on with her life, and this writer has no doubt she will.
October is Breast Cancer Awareness Month.
(You can listen to the podcast version of this article HERE.)


