An Open Letter to Angelina Jolie

Dear Ms. Jolie,

I heard about your courageous decision to have prophylactic bilateral mastectomies and share your story with the world while I was in pre-anesthesia before my own mastectomy. Needless to say, it had an effect on me.

My situation is different from yours. I am also a young woman, 29, but I have no family history of cancer. What brought me to the decision to have a mastectomy was that I had Hodgkin's Lymphoma when I was 15, and was treated with chemo and radiation. The radiation treatments that helped save my life also put me at much higher risk for breast cancer, and so last summer it wasn't entirely a surprise when I turned up with ductal carcinoma in situ (DCIS), a very treatable, non-invasive, pre-cancer. I had a lumpectomy, and a re-excision to make sure the margins were nice and wide. I hoped that would be the end, but my doctors were still urging me to get a mastectomy. If some of my breast tissue responded this way to the radiation treatments once, there was a good possibility they would do it again. On the other hand, I was newly engaged to the love of my life, was only one year into a wonderful and promising ministry as a pastor of two small (growing!) Lutheran congregations, and could nearly taste my lifelong dream of having children and breast-feeding them. I wasn't ready to lose my breasts, and with them, so many dreams. I decided to hang onto both breasts, and my doctors agreed to monitor me closely.

At my six-month check-up, the same thing happened all over again: same breast, DCIS, different location, and presumably an independent development. I couldn't deny it: this would keep happening as long as I had breast tissue, and while so far it had presented itself very early, who was to say I would continue to be so lucky? The one breast had to go. But could I give up both? The right had never had a problem. Was it worth holding onto that breast and my dream of breast feeding? And what girl wants to be making these decisions while she is trying to plan her wedding? In the midst of all this, I was also worried if my perfectly fitting wedding dress would fit properly after treatments!

In the end, I decided I wasn't ready to give up my healthy breast. My surgeon wisely advised me that I needed to be at peace with the decision, and at this point in my life, I could not find peace with giving up everything. So this week, on the day you told the world about your brave decision to give up your breasts for the sake of health, I underwent a single mastectomy to get rid of a persistent pre-cancer.

I read your honest Op Ed, of course. The other stories that I read laud your bravery, which I appreciated and with which I wholeheartedly agree. I know a large part of your purpose was to shine some light on DNA testing and options available for women who carry the so-called "breast cancer gene." I hope and trust this was one outcome of your sharing, but as I said, these particular purposes don't really apply to me. But I do want to tell you what part of your ordeal does speak to me, loud and clear.

You know as well as anyone the emotional impact that goes into the decision to have your breasts removed. Breasts have become such a sex symbol, and to cut them off in what should be the beauty prime of life does not jibe with our cultural instincts. So one of my more emotional struggles in this journey has been that just as I was starting to believe the people who told me I am physically beautiful, I was being forced to take this huge step backwards in the cultural understanding of physical beauty. As much as I know that inside beauty is what counts, and the beauty of my face will still shine brightly (like you, I have a wonderful partner, and he constantly reminds me of this!), it is a hard hit to take. But when I heard the news about you, my first thought was, "What a beautiful decision." It locked into my heart what my brain already knew was true: that beauty goes far beyond boobs.

Perhaps it is ironic that in your story about your breasts, you have taught the world about so much more than breasts. Ms. Jolie, I would like to thank you for showing me and the whole world that while you are one of the most beautiful women in the world, your beauty and beauty in general has little to do with your body. Beauty is health, and being proactive and confident about your health. Beauty is being around for your family. Beauty is sharing your story, whatever you story is. Beauty is courage. You are beautiful, Ms. Jolie. And so am I. And so are the 1 in 8 women who will be diagnosed with breast cancer in their lifetime. And so is anyone who is willing and able to be true to herself and share that self with others.

From one beautiful woman to another, Ms. Jolie: thank you.

Peace,
Johanna Johnson