"I carry a 'faulty' gene, BRCA1, which sharply increases my risk of developing breast cancer and ovarian cancer," wrote Jolie in the op-ed, in which she talked about her late mother Marcheline Bertrand's decade-long battle with cancer and death at 56. "She [Bertrand] 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.
"We often speak of 'Mommy's mommy,' and I find myself trying to explain the illness that took her away from us. They have asked if the same could happen to me. I have always told them not to worry." The truth, however, is that Jolie's doctors estimated that she had an 87 percent risk of developing breast cancer and a 50 percent risk of ovarian cancer. Though she said only a fraction of breast cancers result from an inherited gene mutation, those with a defect in BRCA1 have a 65 percent risk of getting it.
"Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much I could. I made a decision to have a preventive double mastectomy," she wrote of the surgery to remove both breasts. "I started with the breasts, as my risk of breast cancer is higher than my risk of ovarian cancer, and the surgery is more complex."
Jolie said she finished three months of medical procedures on April 27, noting that she kept the mastectomy surgeries private as she continued to work. "But I am writing about it now because I hope that other women can benefit from my experience," she said. "Cancer is still a word that strikes fear into people's hearts, producing a deep sense of powerlessness. But today it is possible to find out through a blood test whether you are highly susceptible to breast and ovarian cancer, and then take action." (Jolie also said she wants to make it a priority for "all women" to be able to be tested for the genes, as it currently costs ore than $3,000.)
Jolie went on to describe the procedure in detail, saying, "It does feel like a scene out of a science-fiction film. But days after surgery you can be back to a normal life. Nine weeks later, the final surgery is completed with the reconstruction of the breasts with an implant. There have been many advances in this procedure in the last few years, and the results can be beautiful."
The actress/director said she decided to write the op-ed to tell other women that her decision was not easy, but that she is happy with her choice, since her 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," she wrote. "It is reassuring that they see nothing that makes them uncomfortable. They can see my small scars and that's it. Everything else is just Mommy, the same as she always was. And they know that I love them and will do anything to be with them as long as I can. On a personal note, I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity."
She praised her "loving and supportive" longtime partner Brad Pitt for supporting her, saying that he was on hand for every minute of the surgeries. "We managed to find moments to laugh together," she wrote. "We knew this was the right thing to do for our family and that it would bring us closer. And it has."
She also encouraged any woman, especially those with a family history of breast or ovarian cancer, to seek out medical advice and make their own informed choice.
"I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer," she said. "It is my hope that they, too, will be able to get gene tested, and that if they have a high risk they, too, will know that they have strong options. Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of."