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关于安吉丽娜·朱莉关于切除乳腺的公开信
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.
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，其他什么都没变，还是他们原来的妈妈。他们知道我是爱他们的，会为了和他们在一起做一切我能做的是。现在，我并没有感觉自己失去了半点女人味，反觉得自己更坚强了。
幸运的是，我的伴侣，布拉德皮特陪在身边关心我支持我。所以我想对那些妻子或女友正在经历这个手术的男士说，你们在这个过程中是非常关键的。我在医院做手术时，皮特每分每秒都在我身边。我们都知道这做这件事对我们的家庭有益，也让我们更加亲密。
读到这封信的女性朋友们，我希望你们知道你们有选择权。我想鼓励每一位女士，特别是有乳腺癌或卵巢癌家族病史的女士，去搜集相关资料、咨询专家，他们能够在这方面帮助到你们，并告诉你们选择。
我感谢轮流为我做手术的优秀的医生们。我自己的经历也会在医院的网站上公布，希望能够帮到其他女性。
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