關(guān)于安吉麗娜·朱莉關(guān)于切除乳腺的公開信

關(guān)于安吉麗娜·朱莉關(guān)于切除乳腺的公開信

原文：

Mymotherfoughtcancerforalmostadecadeanddiedat56.Sheheldoutlongenoughtomeetthefirstofhergrandchildrenandtoholdtheminherarms.Butmyotherchildrenwillneverhavethechancetoknowherandexperiencehowlovingandgraciousshewas.

Weoftenspeakof“Mommy’smommy,”andIfindmyselftryingtoexplaintheillnessthattookherawayfromus.Theyhaveaskedifthesamecouldhappentome.Ihavealwaystoldthemnottoworry,butthetruthisIcarrya“faulty”gene,BRCA1,whichsharplyincreasesmyriskofdevelopingbreastcancerandovariancancer.

MydoctorsestimatedthatIhadan87percentriskofbreastcanceranda50percentriskofovariancancer,althoughtheriskisdifferentinthecaseofeachwoman.

Onlyafractionofbreastcancersresultfromaninheritedgenemutation.ThosewithadefectinBRCA1havea65percentriskofgettingit,onaverage.

OnceIknewthatthiswasmyreality,IdecidedtobeproactiveandtominimizetheriskasmuchIcould.Imadeadecisiontohaveapreventivedoublemastectomy.Istartedwiththebreasts,asmyriskofbreastcancerishigherthanmyriskofovariancancer,andthesurgeryismorecomplex.

OnApril27,Ifinishedthethreemonthsofmedicalproceduresthatthemastectomiesinvolved.DuringthattimeIhavebeenabletokeepthisprivateandtocarryonwithmywork.

ButIamwritingaboutitnowbecauseIhopethatotherwomencanbenefitfrommyexperience.Cancerisstillawordthatstrikesfearintopeople’shearts,producingadeepsenseofpowerlessness.Buttodayitispossibletofindoutthroughabloodtestwhetheryouarehighlysusceptibletobreastandovariancancer,andthentakeaction.

MyownprocessbeganonFeb.2withaprocedureknownasa“nippledelay,”whichrulesoutdiseaseinthebreastductsbehindthenippleanddrawsextrabloodflowtothearea.Thiscausessomepainandalotofbruising,butitincreasesthechanceofsavingthenipple.

TwoweekslaterIhadthemajorsurgery,wherethebreasttissueisremovedandtemporaryfillersareputinplace.Theoperationcantakeeighthours.Youwakeupwithdraintubesandexpandersinyourbreasts.Itdoesfeellikeasceneoutofascience-fictionfilm.Butdaysaftersurgeryyoucanbebacktoanormallife.

Nineweekslater,thefinalsurgeryiscompletedwiththereconstructionofthebreastswithanimplant.Therehavebeenmanyadvancesinthisprocedureinthelastfewyears,andtheresultscanbebeautiful.

Iwantedtowritethistotellotherwomenthatthedecisiontohaveamastectomywasnoteasy.ButitisoneIamveryhappythatImade.Mychancesofdevelopingbreastcancerhavedroppedfrom87percenttounder5percent.Icantellmychildrenthattheydon’tneedtofeartheywilllosemetobreastcancer.

Itisreassuringthattheyseenothingthatmakesthemuncomfortable.Theycanseemysmallscarsandthat’sit.EverythingelseisjustMommy,thesameasshealwayswas.AndtheyknowthatIlovethemandwilldoanythingtobewiththemaslongasIcan.Onapersonalnote,Idonotfeelanylessofawoman.IfeelempoweredthatImadeastrongchoicethatinnowaydiminishesmyfemininity.

Iamfortunatetohaveapartner,BradPitt,whoissolovingandsupportive.Sotoanyonewhohasawifeorgirlfriendgoingthroughthis,knowthatyouareaveryimportantpartofthetransition.BradwasatthePinkLotusBreastCenter,whereIwastreated,foreveryminuteofthesurgeries.Wemanagedtofindmomentstolaughtogether.Weknewthiswastherightthingtodoforourfamilyandthatitwouldbringuscloser.Andithas.

Foranywomanreadingthis,Ihopeithelpsyoutoknowyouhaveoptions.Iwanttoencourageeverywoman,especiallyifyouhaveafamilyhistoryofbreastorovariancancer,toseekouttheinformationandmedicalexpertswhocanhelpyouthroughthisaspectofyourlife,andtomakeyourowninformedchoices.

Iacknowledgethattherearemanywonderfulholisticdoctorsworkingonalternativestosurgery.MyownregimenwillbepostedinduecourseontheWebsiteofthePinkLotusBreastCenter.Ihopethatthiswillbehelpfultootherwomen.

Breastcanceralonekillssome458,000peopleeachyear,accordingtotheWorldHealthOrganization,mainlyinlow-andmiddle-incomecountries.Ithasgottobeaprioritytoensurethatmorewomencanaccessgenetestingandlifesavingpreventivetreatment,whatevertheirmeansandbackground,wherevertheylive.ThecostoftestingforBRCA1andBRCA2,atmorethan$3,000intheUnitedStates,remainsanobstacleformanywomen.

Ichoosenottokeepmystoryprivatebecausetherearemanywomenwhodonotknowthattheymightbelivingundertheshadowofcancer.Itismyhopethatthey,too,willbeabletogetgenetested,andthatiftheyhaveahighriskthey,too,willknowthattheyhavestrongoptions.

Lifecomeswithmanychallenges.Theonesthatshouldnotscareusaretheoneswecantakeonandtakecontrolof.

AngelinaJolieisanactressanddirector.

譯文：

我母親在與癌癥斗爭了十年，一直堅持到看到自己的第一個孫子出身，將他攬入懷中，但她最后在五十六歲時過世。我其他的孩子就沒能夠與她相處了，也無法知道她是一個多可愛多親切的外婆。

每次我和孩子們談及外婆時，我總想能夠解釋清楚是什么病奪去了他們的外婆。于是孩子們會問，是否這些會發(fā)生在我身上，我告訴孩子們沒什么好擔(dān)心的。但實際上，我身上帶有一種能夠大幅度增加患乳腺癌和卵巢癌的可能的基BRCA1。

每個帶有該基因的人發(fā)病概率各不同，我的醫(yī)生估計，我患上乳腺癌的幾率大約是87%，卵巢癌的幾率是50%。雖然大部分的乳腺癌病例都非基因所致，但是帶有BRCA1基因的人患乳腺癌的幾率比平常人平均高出65%。

當(dāng)我認(rèn)定“這就是事實”的時候，我決定提前做好預(yù)防，選擇了做雙乳切除手術(shù)以減少得病幾率。一方面因為自己患乳腺癌的可能性比卵巢癌要高，另一方面也因為這個手術(shù)比較復(fù)雜。

四月二十七日，結(jié)束了為期三個月的治療過程。在這期間，我一邊保守這個消息，一邊也沒有放下工作。

但是現(xiàn)在我寫這封信將這件事告之于眾，其原因是我希望其他女性能夠從中獲益。癌癥確實讓人們害怕，不過如今已經(jīng)可以通過血液檢查來測定患乳腺癌和卵巢癌的幾率。如果這個幾率很高，也可以做出反應(yīng)。

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