關于安吉麗娜·朱莉關于切除乳腺的公開信
原文：
My mother fought cancer for almost a decade and died at 56. She held out long enough to meet the first of her grandchildren and to hold them in her arms. But my other children will never have the chance to know her and experience how loving and gracious she was.
We often speak of “Mommy’s mommy,” and I find myself trying to explain the illness that took her away from us. They have asked if the same could happen to me. I have always told them not to worry, but the truth is I carry a “faulty” gene, BRCA1, which sharply increases my risk of developing breast cancer and ovarian cancer.
My doctors estimated that I had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer, although the risk is different in the case of each woman.
Only a fraction of breast cancers result from an inherited gene mutation. Those with a defect in BRCA1 have a 65 percent risk of getting it, on average.
Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much I could. I made a decision to have a preventive double mastectomy. I started with the breasts, as my risk of breast cancer is higher than my risk of ovarian cancer, and the surgery is more complex.
On April 27, I finished the three months of medical procedures that the mastectomies involved. During that time I have been able to keep this private and to carry on with my work.
But I am writing about it now because I hope that other women can benefit from my experience. Cancer is still a word that strikes fear into people’s hearts, producing a deep sense of powerlessness. But today it is possible to find out through a blood test whether you are highly susceptible to breast and ovarian cancer, and then take action.
My own process began on Feb. 2 with a procedure known as a “nipple delay,” which rules out disease in the breast ducts behind the nipple and draws extra blood flow to the area. This causes some pain and a lot of bruising, but it increases the chance of saving the nipple.
Two weeks later I had the major surgery, where the breast tissue is removed and temporary fillers are put in place. The operation can take eight hours. You wake up with drain tubes and expanders in your breasts. It does feel like a scene out of a science-fiction film. But days after surgery you can be back to a normal life.
Nine weeks later, the final surgery is completed with the reconstruction of the breasts with an implant. There have been many advances in this procedure in the last few years, and the results can be beautiful.
I wanted to write this to tell other women that the decision to have a mastectomy was not easy. But it is one I am very happy that I made. My chances of developing breast cancer have dropped from 87 percent to under 5 percent. I can tell my children that they don’t need to fear they will lose me to breast cancer.
It is reassuring that they see nothing that makes them uncomfortable. They can see my small scars and that’s it. Everything else is just Mommy, the same as she always was. And they know that I love them and will do anything to be with them as long as I can. On a personal note, I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity.
I am fortunate to have a partner, Brad Pitt, who is so loving and supportive. So to anyone who has a wife or girlfriend going through this, know that you are a very important part of the transition. Brad was at the Pink Lotus Breast Center, where I was treated, for every minute of the surgeries. We managed to find moments to laugh together. We knew this was the right thing to do for our family and that it would bring us closer. And it has.
For any woman reading this, I hope it helps you to know you have options. I want to encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices.
I acknowledge that there are many wonderful holistic doctors working on alternatives to surgery. My own regimen will be posted in due course on the Web site of the Pink Lotus Breast Center. I hope that this will be helpful to other women.
Breast cancer alone kills some 458,000 people each year, according to the World Health Organization, mainly in low- and middle-income countries. It has got to be a priority to ensure that more women can access gene testing and lifesaving preventive treatment, whatever their means and background, wherever they live. The cost of testing for BRCA1 and BRCA2, at more than $3,000 in the United States, remains an obstacle for many women.
I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer. It is my hope that they, too, will be able to get gene tested, and that if they have a high risk they, too, will know that they have strong options.
Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of.
Angelina Jolie is an actress and director.
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，是否這些會發生在我身上，我告訴孩子們沒什么好擔心的。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病概率各不同，我的醫生估計，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%。
當我認定“這就是事實”的時候，我決定提前做好預防，選擇了做雙乳切除手術以減少得病幾率。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比較復雜。
四月二十七日，結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。
我的手術是從二月二日開始的。最開始做了一個乳頭保留術，這個過程十分疼痛，但是能夠幫助保留乳頭和乳暈部分。兩周后，手術進行到主要過程。乳房組織被移出，注入暫時填充物。手術進行了八個小時。朱莉稱，醒來時滿身的儀器，就像在科幻電影中。而幾天后，就能夠正常生活。九周后，手術的最后一個階段也就是乳房重建。這項技術在近些年得到了較大發展，重建后的乳房會很漂亮。
我想通過這封信告訴大家，做這個決定并非易事。但是我很高興自己做了這個決定。現在，我患乳腺癌的幾率從87%降到了5%。終于可以告訴孩子們不必擔心會因為乳腺癌而失去他們的母親。欣慰的是，孩子們對這個過程一無所知，他們能夠看到的僅僅是一個小傷疤，其他什么都沒變，還是他們原來的媽媽。他們知道我是愛他們的，會為了和他們在一起做一切我能做的是。現在，我并沒有感覺自己失去了半點女人味，反覺得自己更堅強了。
幸運的是，我的伴侶，布拉德皮特陪在身邊關心我支持我。所以我想對那些妻子或女友正在經歷這個手術的男士說，你們在這個過程中是非常關鍵的。我在醫院做手術時，皮特每分每秒都在我身邊。我們都知道這做這件事對我們的家庭有益，也讓我們更加親密。
讀到這封信的女性朋友們，我希望你們知道你們有選擇權。我想鼓勵每一位女士，特別是有乳腺癌或卵巢癌家族病史的女士，去搜集相關資料、咨詢專家，他們能夠在這方面幫助到你們，并告訴你們選擇。
我感謝輪流為我做手術的優秀的醫生們。我自己的經歷也會在醫院的網站上公布，希望能夠幫到其他女性。
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