Our goal is to increase awareness about non-narcotic pain control options available before, during, and after surgical procedures that are so effective that needing narcotics postoperatively is dramatically reduced or even eliminated.

Risk reduction for BRCA2 carriers includes taking tamoxifen. Removing ovaries prior to age 40 drops breast cancer risk in half. Ovarian cancer surveillance is unfortunately inadequate at early detection, but birth control pills reduce ovarian cancer incidence up to 60%.

It is absolutely a good thing that she [Angelina Jolie] helped to educate the world about the existence of this mutation; hopefully, as a result, more compassionate understanding exists regarding the choices BRCA carriers must face.

By empowering people to initiate a conversation prior to surgery regarding their pain control options, we hope to reduce the incidence of narcotic addiction and all of the unfortunate consequences that surround it.

The Angelina Effect refers to the fact that a powerful, beautiful, well-respected and world-renowned woman unabashedly revealed private medical details about a gene mutation which affects 1 in 500 people. In so doing, she raised awareness and sparked conversations around the world amongst known BRCA carriers, possible carriers, and the circle of family and friends who care about them.

Options other than mastectomy include high risk surveillance and risk reduction. Surveillance is a combination of monthly self breast exam, annual mammography and whole breast screening ultrasound, annual breast MRI, and biannual clinical breast exam.

In my practice, the majority of mutation carriers choose mastectomy; however, for those without cancer, they have much more control over the timing. For younger women, we might wait until they have found a life partner, or until after childbearing. Older women who find out they carry a mutation have unwittingly escaped a large percentage of their risk, and therefore, the calculated future risk is not necessarily a daunting number.