关于安吉丽娜·朱莉关于切除乳腺的公开信原文: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.译文:我母亲在与癌症斗争了十年,一直坚持到看到自己的第一个孙子出身,将他揽入怀中,但她最后在五十六岁时过世。我其他的孩子就没能够与她相处了,也无法知道她是一个多可爱多亲切的外婆。每次我和孩子们谈及外婆时,我总想能够解释清楚是什么病夺去了他们的外婆。于是孩子们会问,是否这些会发生在我身上,我告诉孩子们没什么好担心的。但实际上,我身上带有一种能够大幅度增加患乳腺癌和卵巢癌的可能的基BRCA1。每个带有该基因的人发病概率各不同,我的医生估计,我患上乳腺癌的几率大约是87%,卵巢癌的几率是50%。虽然大部分的乳腺癌病例都非基因所致,但是带有BRCA1基因的人患乳腺癌的几率比平常人平均高出65%。当我认定“这就是事实”的时候,我决定提前做好预防,选择了做双乳切除手术以减少得病几率。一方面因为自己患乳腺癌的可能性比卵巢癌要高,另一方面也因为这个手术比较复杂。四月二十七日,结束了为期三个月的治疗过程。在这期间,我一边保守这个消息,一边也没有放下工作。但是现在我写这封信将这件事告之于众,其原因是我希望其他女性能够从中获益。癌症确实让人们害怕,不过如今已经可以通过血液检查来测定患乳腺癌和卵巢癌的几率。如果这个几率很高,也可以做出反应。我的手术是从二月二日开始的。最开始做了一个乳头保留术,这个过程十分疼痛,但是能够帮助保留乳头和乳晕部分。两周后,手术进行到主要过程。乳房组织被移出,注入暂时填充物。手术进行了八个小时。朱莉称,醒来时满身的仪器,就像在科幻电影中。而几天后,就能够正常生活。九周后,手术的最后一个阶段也就是乳房重建。这项技术在近些年得到了较大发展,重建后的乳房会很漂亮。我想通过这封信告诉大家,做这个决定并非易事。但是我很高兴自己做了这个决定。现在,我患乳腺癌的几率从87%降到了5%。终于可以告诉孩子们不必担心会因为乳腺癌而失去他们的母亲。欣慰的是,孩子们对这个过程一无所知,他们能够看到的.仅仅是一个小伤疤,