“It is important to talk about topics such as the prophylactic mastectomy” for women with genetic mutations that amplify the risk of breast and ovarian cancer. US actress “Angelina Jolie was the first to do it in 2013 and it was helpful, it rocked the boat both medically and opinionally public”. Now the Italian model Bianca Balti is talking about herself on social media. Talking about it is good for Viviana Galimberti, director of the Breast Division of the European Institute of Oncology (IEO) in Milan. of the health system, it is not recognized – he underlines to Adnkronos Salute – It is serious. The health system provides and ensures constant monitoring with free ultrasounds, mammograms and MRIs, but it does not cover the health costs for those who choose and want to undergo prophylactic surgery”.
“We specialists went to Rome to make a statement in the Senate – highlights the specialist, who also underwent prophylactic surgery – In hospitals, our hands are somewhat tied on this issue: we have women who want to make these choices, but we have a longer waiting list precisely because, since it is not a reimbursed intervention, there are difficulties”. Thus prevention is limited, observes Galimberti, “while investing also in these pathways would in any case lead to subsequent savings, in the sense that there would be fewer necessary checks and then there would be no tumors that would develop”.
Waiting today “can be as long as a year – continues the expert – There are women who are on the list and who have already developed cancer. This surgery has significant costs, we try to do it anyway, to overcome and ignore the difficulties even if we are held back by the administrations. And we will fight with all the changed women’s associations that are moving and are pushing for this to be recognized also at the insurance level”. Today there are still obstacles to achieving full access to this option, she assures. “It’s a serious problem.”
The hope is that the level of attention for these women will rise. Surely Bianca Balti’s social story on her choice to undergo a preventive double mastectomy, as a carrier of the risky mutation in the Brca1 gene, had the effect of turning the spotlight on the topic. “When Jolie spoke about it in 2013, it was already known that these genes existed, but it was useful” that ample space was given to the debate, recalls Galimberti. “Maybe it was a little confusing at first because all the women came and asked to have the genetic test done, but not everyone can and should do it. There are risk categories, established by geneticists based on family history , age, whether or not they’ve had other cancers. So we had to explain a lot.”
But “the information was important and women are now aware, they ask – the breast specialist remarks – And it is right that we doctors always offer these tests and genetic investigations when needed, because they can change the perspective even in a woman who has cancer and he can choose not only to have conservative surgery, but to have both breasts removed for example”. Galimberti has personally experienced the choice of prophylactic surgery for herself and explains that “it is a very personal path. Every woman is different. This is also the beauty of medicine, which is not so schematic”, reflects the specialist who has also wrote a book, ‘Precious scars’ (Rizzoli publisher).
“It sounds like an oxymoron, but scars – he clarifies – are always a memory, they can be on the skin, but also internal, linked to losses, mourning. They become precious the moment I process them, I make peace with them, I understand what’s behind and if this can lead me to improve.I must say that many women who undergo breast surgery, if they are no longer angry and are able to elaborate, are able to bring out the best part of themselves and to love themselves even a little more. Scars can therefore become precious, but this also depends a little on us”, he concludes.
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