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Breast Cancer and Baseball

When 31-year-old LA Dodgers pitcher Tommy John developed a sore arm in 1973, his pitching career appeared to be over.   His UCL (ulnar collateral ligament) had become stretched, frayed, and torn due to the extreme repetitive stress of the pitching motion – pretty much a death knell for a big league pitcher’s career.

Frank Jobe, the Dodgers team physician, had been working on an idea. He felt that he could try to replace the damaged ligament with a tendon taken from somewhere else on John’s body. He would drill holes in the elbow bones, and weave the harvested tendon in a figure eight pattern through the holes, essentially fabricating a new UCL. Jobe thought it was a long shot, putting the odds of success at 1 in a 100, but with John’s career hanging in the balance, and no other options, the two decided to give it a try.

The surgery worked, and Tommy John went on to win another 164 games, pitching until the age of 46, enjoying one of the longest careers in the history of major American professional sports.

The surgery was revolutionary, and now carries the name “Tommy John surgery”. Every year, many pitchers at all levels undergo the surgery, with current success rates estimated at approximately 94 percent. In the majority of cases, pitchers return from the surgery throwing harder than they did prior to the injury.

The subtle change in some patient’s mindset from “I have to have Tommy John surgery” to “I get to have Tommy John surgery” is remarkable.

So what does this have to do with breast cancer? Enter Angelina Jolie, the Hollywood beauty (whose surname is the French word for “pretty”) known for her full lips and the even fuller décolletage. Those breasts were a threat, however: Given her family history of ovarian and breast cancer, she underwent a genetic test that confirmed a BRCA1 mutation, with sky-high odds (60-87 percent) that she would develop breast cancer at some point in her life.

Since few actresses have successfully returned to careers after breast cancer surgery and treatment, Angelina decided to nip it in the bud, so to speak. With the aim of helping other women make informed health choices, Jolie went public with her decision last May when she announced in a poignantly worded New York Times op-ed that she had undergone nipple-sparing prophylactic mastectomy and reconstruction. Her procedure involved removing all breast tissue and reconstruction with silicone implants.

Though more women are electing to have this surgery to prevent breast cancer, Jolie’s celebrity caused a media firestorm. Here was one of the world’s most beautiful women, deciding to undergo revolutionary, radical surgery that would allow her to preserve both her health and her beauty.

With more people talking about “Angelina Jolie Surgery,” it’s hard to ignore the parallels to Tommy John. While it would not be entirely accurate to say that either pitchers or women emerge from these surgeries better than before, how wonderful it is that, due to marvelous advances in medicine, so many patients “get to have” these operations, and remain strong, beautiful and productive for many years to come.

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