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Osnaživanje, stil i inspiracija spajaju se u svakom izdanju našeg magazina.
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March 20, 2026
Is breast cancer an intimate story for you? One deeply familiar to your mother, aunt, or sisters? One that has made you hear the phrase preventive double mastectomy at least once? If so, this is a story for you.
By Hana Dunđerov
In my early teenage years, I became familiar with terms like Pap smear, mammography, breast ultrasound, and tumor markers. My mother survived breast cancer, and shortly after that, cervical cancer. My paternal grandmother—an Ashkenazi woman, a detail that will matter later—had ovarian changes. Recently, my aunt overcame an aggressive form of breast cancer. And it wasn’t her first time: decades earlier, she had fought cancer of the reproductive organs. Because of all this, I learned early on that the first thing to mark in my calendar is my gynecological check-up—and my mammogram. Yes, I’ve been doing it since I was 35.
Still, the first time I heard the words “preventive double mastectomy,” I was stunned. I had just completed a routine breast ultrasound, relieved that everything looked normal, when my doctor stopped me:
“Given your family history, I would recommend a preventive bilateral mastectomy. You know what that is, right?”
Of course I did. The whole world did after 2013, when Angelina Jolie made her decision public. But even knowing my family history, even with regular check-ups, it had never occurred to me that this might be a decision I would one day face. Before hormonal changes set in. Before estrogen and progesterone increase the likelihood of developing breast cancer.
After the initial shock, what I felt was gratitude. Gratitude toward my doctor, toward medicine, toward life—and yes, even toward Angelina Jolie. Because preventive double mastectomy is not a sentence. It is a choice. One that exists for women whose lives have been shaped by stories of breast cancer passed down through generations.
The “Jolie Effect” and the Power of Choice
When Angelina Jolie publicly shared in 2013 that she had undergone a preventive double mastectomy, the world learned—en masse—about the BRCA1 and BRCA2 genes. In her personal essay for The New York Times, she spoke openly about her decision, her fear of inheriting cancer, and her desire to remain a healthy mother for as long as possible.
Many women had faced hereditary breast cancer before, but her story introduced something new to the public conversation: the idea of choice. A difficult one, certainly—but a real one. Following her announcement, both preventive mastectomy and genetic testing for BRCA mutations entered everyday vocabulary.
Her decision sparked a global wave of reactions. In the months that followed, interest in genetic testing and preventive screenings surged. Experts called this phenomenon the “Jolie effect,” as her openness brought the topic of hereditary cancer risk out of medical offices and into public discourse. More importantly, it changed how women think about prevention. Conversations around BRCA genes, preventive surgery, and genetic counseling became more open, less stigmatized, and more informed. For many women, it was the first time they learned that risk can be assessed, monitored—and, in some cases, significantly reduced.
What Are BRCA1 and BRCA2 Genes—and Why Do They Matter?
BRCA1 and BRCA2 are genes present in every person. Their role is to repair DNA damage and prevent uncontrolled cell growth, which is why they are often called tumor suppressor genes.
The problem arises when one of these genes is inherited in a mutated form. In that case, the DNA repair mechanism doesn’t function properly, allowing errors to accumulate in cells—potentially leading to cancer. The most common are breast and ovarian cancers, though BRCA mutations can increase the risk of other malignancies as well.
It’s important to understand that a positive BRCA mutation does not mean you will definitely develop cancer. It means your risk is significantly higher than average. Because of this elevated risk, BRCA mutations are a key factor when considering preventive measures—one of which is preventive mastectomy, the surgical removal of breast tissue before cancer develops. Studies show that this procedure can reduce the risk of breast cancer by more than 90% in women who carry the mutation.
Is Preventive Double Mastectomy the Right Choice for You?
Science is clear: preventive mastectomy is recommended only for women with confirmed BRCA1 or BRCA2 mutations—like Angelina Jolie. Research suggests that women with average risk, even those who have had cancer in one breast, do not benefit from removing both breasts. Survival rates between those who undergo the procedure and those who don’t are nearly identical in such cases.
However, for women with BRCA mutations, the picture changes dramatically. Preventive removal of the breasts can increase survival chances to as high as 90–95%.
Is Preventive Mastectomy Covered by the State in Serbia?
In theory, yes—but only in very limited cases. Approval must come from a medical board that includes both an oncologist and a geneticist. To even be considered, you must provide evidence of a strong family history of breast cancer or a confirmed BRCA mutation.
Testing is most often done in private laboratories, costing between €420 and €650. State-funded testing is available, but only if specialists at the Institute of Oncology and Radiology determine it is justified. You may qualify for free testing if:
If You Test Positive, Is Surgery the Only Option?
Absolutely not. A mutation increases your risk—but it does not guarantee disease. For example:
BRCA1
Lifetime breast cancer risk: approximately 60–80%
Ovarian cancer risk: around 35–45%
BRCA2
Breast cancer risk: about 50–70%
Ovarian cancer risk: around 10–25%
Cancer development is influenced by many factors—other genes, lifestyle, hormones, biology, and even chance. If you choose not to undergo surgery, strict and regular monitoring becomes essential.
For women with BRCA mutations, research recommends:
For breast health:
After age 25: annual MRI
After age 35: alternating MRI and mammography
After age 40: ultrasound every 6 months and annual mammography
For ovarian health:
CA-125 tumor marker testing every 6–12 months, starting at age 25
In Serbia, guidelines are slightly different: breast ultrasound every 6 months, annual mammography after age 35, and yearly gynecological exams with tumor markers.
A positive BRCA result is not a sentence—it’s a warning. One that allows for earlier monitoring, more advanced treatment options, and, in some cases, life-saving preventive action. Use it.
Photo: Shutterstock
