Host 1: Dr. Lisa Cassileth is a Beverly Hills plastic and reconstructive surgeon who has
also appeared on numerous shows.
You've probably seen her on -- Host 2: Nightline, The Doctors...
Host 1: All sorts of shows, yes.
So she joins us right now, Dr. Lisa, welcome to TMZ live.
Dr. C: Hi, thanks.
Host 1: What about the decision essentially...
in a sense, it's kind of like playing the odds in Vegas, that she had an extremely high
percentage rate of getting breast cancer and she de3cided to cut it off at the pass.
Dr. C: Right; a lot of these women now are finding out, let's say, if their mom had breast
cancer at an early age.
First I have to figure out do I even get tested because now it's pretty obvious if you have
positive -- especially look at her, over 80% odds.
Overall, it's over 60% chance that you carry the genes.
You will get breast cancer.
So you have to go through chemotherapy or radiation or the other things actually associated
with getting cancer; it's such a big deal and so potentially negative...
you can die from breast cancer as well.
Bit to go ahead and get a mastectomy makes a lot more sense.
Host 1: So this I understand, is something where they don't necessarily do the surgery,
if somebody were to find this out in their 20s, they wouldn't necessarily do it on their
20s, they would wait.
I read this today, they would wait until possibly the person was around 40 years old, is that
correct?
Dr. C: Actually, we usually do it in the 30s.
And some people, depending on the gene mutation because not all gene mutations are the same.
Some women who rack up positive actually in their 20s.
So there's not one vanilla style.
Some people even having mastectomies when they are very young if they're in the higher
risk form of the mutation.
Host 1: So of somebody had Angelina's mutation, the same form of mutation and they tested
in their 20s.
would a doctor recommend for them to wait until they got into their 30s or would they
do the procedure then?
Dr. C: I don't know what her exact mutation was but of course she waited until she was
a little older and it worked out fine.
With her, her mother also had a fairly aggressive form of breast cancer so...
There's no doubt that she was at higher risk and that it was a good idea for the preservation
of her life, her well-being, to be able to do it.
Then you could do other things that are cosmetically better, too.
You know, nipple sparing procedures; so these women basically have normal-looking breasts
when they're done with their reconstruction.
Host 1: So Lisa, if you could tell us about that because we were just talking about the
fact that Angelina went through this over several months and was still out in public,
and nobody was any wiser that this was going on.
Is that a testament to the reconstruction?
Dr. C: For sure there is a shift in the way that breast reconstruction is done.
Old school was that everyone got big cut all the way across their chest, you don't have
any kind of normal... the nipple and aureoles was completely gone, there was no breast reconstruction.
Well now, what everyone is doing is first putting in a tissue expander which is this
kind of space-saving device which allows you to spare all the skin of the breast and then
later swapping it out for the final implants.
Host 1: I would think there would be a seismic change in terms of a) the number of women
who are being tested and B)
the number of women who are following her course of treatment.
Dr. C: Exactly.
Take for the attention that this is going to make for women that potentially have these
genes who are walking around like time bombs, when they could have work done, have a fantastic
outcome.
Maybe they're not going to be on the red carpet but hey, they can function in their normal
life day to day, take care of their kids, still be successful and meanwhile have a great
outcome just like she has.
Host 1: Thank you so much for joining us.
Really appreciate it, this is interesting.
Really appreciate your time.
Dr. C: My pleasure.