Angelina Jolie says that she has had a preventive double mastectomy after learning she carried a gene that made it extremely likely she would get breast cancer.
The Oscar-winning actress and partner to Brad Pitt made the announcement in the form of an op-ed she authored for Tuesday’s New York Times under the headline, “My Medical Choice.” She writes that between early February and late April she completed three months of surgical procedures to remove both breasts.
Jolie, 37, writes that she made the choice with thoughts of her six children after watching her own mother, actress Marcheline Bertrand, die too young from cancer.
“My mother fought cancer for almost a decade and died at 56,” Jolie writes. “She held out long enough to meet the first of her grandchildren and to hold them in her arms. But my other children will never have the chance to know her and experience how loving and gracious she was.”
She writes that, “They have asked if the same could happen to me.”
Jolie said that after genetic testing she learned she carries the “faulty” BRCA1 gene and had an 87 percent chance of getting the disease herself.
She said she has kept the process private so far, but wrote about it with hopes of helping other women.
“I wanted to write this to tell other women that the decision to have a mastectomy was not easy. But it is one I am very happy that I made,” Jolie writes. “My chances of developing breast cancer have dropped from 87 percent to under 5 percent. I can tell my children that they don’t need to fear they will lose me to breast cancer.”
Phone and email messages left by The Associated Press late Monday night seeking comment from Jolie representatives were not immediately returned.
She is anything but private in the details she provides, giving a description of the procedures.
“My own process began on Feb. 2 with a procedure known as a ‘nipple delay,’” she writes, “which rules out disease in the breast ducts behind the nipple and draws extra blood flow to the area.”
She then describes the major surgery two weeks later where breast tissue was removed, saying it felt “like a scene out of a science-fiction film,” then writes that nine weeks later she had a third surgery to reconstruct the breasts and receive implants."
Many women have chosen preventive mastectomy since genetic screening for breast cancer was developed, but the move and public announcement is unprecedented from a star so young and widely known as Jolie.
She briefly addresses the effects of the surgery on the idealized sexuality and iconic womanhood that have fueled her fame.
“I do not feel any less of a woman,” Jolie writes. “I feel empowered that I made a strong choice that in no way diminishes my femininity.”
She also wrote that Brad Pitt, her partner of eight years, was at the Pink Lotus Breast Center in Southern California for “every minute of the surgeries.”
Bertrand, Jolie’s mother, died in January 2007. She had small roles in the movies “Lookin’ to Get Out” in 1982 and “The Man Who Loved Women” in 1983. She raised Jolie and her brother after divorcing their father, Oscar-winning actor Jon Voight, when Jolie was a toddler.
Jolie has appeared in dozens of films including 2010’s “The Tourist” and “Salt,” the “Tomb Raider” films, and 1999’s “Girl, Interrupted,” for which she won an Academy Award.
But she has appeared more often in the news in recent years for her power coupling with Pitt and her charitable work with refugees as a United Nations ambassador.
Meanwhile, CNN anchor Zoraida Sambolin announced Tuesday she has breast cancer and is getting a double mastectomy.
Sambolin, who anchors CNN’s “Early Start” morning show, talked about her condition on the show Tuesday while discussing Jolie’s decision.
Here’s a crash course in the procedure Jolie had and why.
Q: What kind of surgery did Jolie have?
A: Jolie had a preventive double mastectomy, meaning she chose to have both her breasts removed even though she had not been diagnosed with cancer.
Q: Why did she have the mastectomies?
A: Jolie says that she has a “faulty” version of the BRCA1 gene that means she had an 87 percent chance of getting breast cancer. By having both breasts removed preventively, she said her breast cancer risk drops to below 5 percent.
Q: What did the procedure involve?
A: In double mastectomies, surgeons typically remove as much breast tissue as possible. In Jolie’s case, because she was having a reconstruction done shortly afterward, the doctors preserved the skin covering her breasts, inserting “fillers” where the breast tissue would have been, to keep the skin elastic. According to Jolie, she had implants put in nine weeks later.
Q: How many women have this faulty gene?
A: Only a small percentage of women have this same faulty gene, or a similar mutated version of a related gene, BRCA2. These mutations are most commonly found in women of Eastern European Jewish descent; one study found 2.3 percent of women in that group had the mutations — about five times higher than in the general population. Other ethnic groups, including the Norwegian, Dutch and Icelandic people, also have slightly higher rates of these mutations.
Q: How do these genes increase a woman’s risk of breast cancer?
A: The average woman has a 12 percent risk of developing breast cancer sometime during her life. In comparison, women who have inherited a faulty version of a breast cancer gene are about five times more likely to get breast cancer. In the U.S., about 5 to 10 percent of breast cancers are thought to be linked to harmful versions of the BRCA1 and BRCA2 genes.
Q: How can women find out if they have these gene mutations?
A: A genetic test using a blood test can usually detect these genes. In the U.S., there are no standard guidelines recommending women for BRCA1 or BRCA2 genetic testing. The test can cost several thousand dollars but may often be covered by insurance companies if women have risk factors that justify it. Women may be at higher risk for having a harmful mutation if they have close family members diagnosed with breast or ovarian cancer at an early age. Jolie says that her mother fought cancer for nearly a decade before dying at age 56.
Q: What other options might Jolie have had?
A: Doctors would likely have suggested earlier screening tests, including mammograms or MRIs, but those would only help them spot breast cancer earlier, not prevent it. They might also consider using breast cancer drugs preventively, though trials into their long-term use are still ongoing. “This is not a decision that people take lightly,” said Dr. Emma Pennery, clinical director at the British charity, Breast Cancer Care. “You cannot decide to have a double mastectomy next week.”
Q: How relevant is Jolie’s decision to other women?
A: For most women, genetics will not play a big part in whether or not they get breast cancer. “The majority of women considering their breast cancer risk should focus on things like a healthy lifestyle, eating a balanced diet, keeping a healthy weight and not drinking too much alcohol,” said Dr. Peter Johnson, chief clinician at Cancer Research U.K. About one third of breast cancer cases in Britain are largely tied to modifiable lifestyle risk factors.
But for women with a similar genetic risk to Jolie, it’s possible her decision to go public about her double mastectomies will prompt more procedures. “It’s a very empowering message that women are not helpless when faced with a genetic cancer risk,” Johnson said.