Recently, the famous actress Angelina Jolie announced that she had undergone a preventive bilateral mastectomy with reconstructive prosthesis in order to prevent breast cancer because she carries a mutated BRCA1 gene and has a very high risk of developing breast cancer (87% predicted by US experts). Breast cancer is currently the number one killer related to female tumors worldwide, and mastectomy is an effective means of treatment or prevention; however, breasts are not only a simple breastfeeding organ for women, but also an important symbol of female beauty, as they are a concentrated expression of femininity and physical beauty. So is it true that for those who are at high risk of breast cancer, or breast cancer patients, they must give up the symbol of female beauty in order to continue their lives? Is it true that beauty and life are inseparable for these women? Let’s start with Angelina Jolie’s decision. Let’s start with Angelina Jolie’s decision. To discuss Jolie’s decision, it is important to first understand the BRCA1 gene. What is BRCA1 and does it mean breast cancer? The normal BRCA1 is a gene that controls DNA repair, but when mutated, it greatly increases the risk of breast and ovarian cancer in carriers. Probabilistically, women who carry the mutated BRCA1 gene have about a 60% risk of developing breast cancer, which is five times higher than normal women (about 12% for normal women). Although breast cancer prevention and diagnosis has entered the era of genetic testing, genetic testing can only provide a general probability estimate to the target population, and no one can accurately predict the specific individual. Take Jolie as an example, she carries a mutated BRCA1 gene, and together with some other susceptibility factors, the risk of developing breast cancer is finally calculated to be 87%, but whether and when she will eventually get breast cancer is something no one can predict. So for women at high risk, is it necessary to undergo double mastectomy? Double mastectomy is certainly an effective way to reduce risk, but it is also one of the most radical. In fact, there are a number of ways to reduce risk while retaining beauty, especially in this country, and the vast majority of experts do not recommend double mastectomy as a way to reduce breast cancer risk. First, and most simply, early diagnosis and treatment can be achieved through close observation. For women with BRCA1 mutation, breast cancer screening can be done early, starting with annual breast cancer imaging screening at the age of 25-30. Many early breast cancers can be detected by breast ultrasound, mammogram, MRI, etc. A significant proportion of these patients can retain their breasts in treatment and get long-term survival. Secondly, prevention can also be done through medications. Tamoxifen is a recognized drug for reducing the risk of breast cancer, both as a preventive drug for women at high risk of developing the disease and as a therapeutic drug for breast cancer patients. Studies have shown that oral tamoxifen for 5 years can effectively reduce the risk of breast cancer by 49%, and for women with a history of atypical breast enlargement, it can even reduce the risk of breast cancer by 86%. For prevention, it is possible to achieve both beauty and life. What about for breast cancer patients? In fact, for many breast cancer patients, appropriate surgical procedures and treatments can also make beauty and life go on together. First of all, for most of the early stage breast cancer patients, the removal of the lesion and the surrounding part of the breast is sufficient, and the appropriate mammoplasty to fill the breast depressions in the affected area, followed by radiotherapy and appropriate systemic treatment, can give the patient a very good prognosis. This is commonly referred to as radical mastectomy with breast preservation, which cures breast cancer while preserving the normal breast on the affected side, with no significant postoperative changes in breast shape. Secondly, some patients who are unable to undergo breast-conserving surgery due to other reasons such as large lumps or multiple lumps may undergo mastectomy + reconstruction surgery. The procedure is the same as a standard radical mastectomy, except that a reconstructive mastectomy is performed at the same time. Reconstruction is broadly divided into prosthesis and autologous reconstruction. Prosthetic reconstruction is similar to the familiar breast augmentation, in which silicone gel is implanted behind the pectoral muscle, which is a simple and less invasive procedure. In autologous reconstruction, we take our own tissues (such as latissimus dorsi muscle and abdominal musculocutaneous flap) and fill the breast defect with our own. However, the postoperative results are significantly better than those of prosthetic reconstruction, with satisfactory shape and feel, as well as the cosmetic effect of abdominal reduction. To sum up, beauty and life are not a pair of enemies in the face of breast cancer. Let’s work together to see life continue in beauty!