Allowing others to have Jolie’s ‘choice’

Hollywood actress Angelina Jolie has undergone a double mastectomy. Not because she had breast cancer, but to reduce her chances of getting it.

The 37-year-old mother of six explained her reasoning in a New York Times essay on Tuesday. In her article headlined “My Medical Choice,” Jolie explained that her mother, actress Marcheline Bertrand, fought cancer for nearly a decade and died at the age of 56. Her own doctors estimated she had an 87 percent risk of breast cancer and a 50 percent risk of ovarian cancer.

“I decided to be proactive and to minimize the risk as much I could,” she wrote.

She said the process began in February and was completed by the end of April.

About one in five women diagnosed with breast cancer will have a significant family history of the disease. Certain genes such as BRCA1 and BRCA2 are strongly linked with breast cancer and can be detected with genetic tests. Women carrying the BRCA1 mutation have up to a 65 percent chance of developing breast cancer by the time they are 70.

She said that once she “knew that this was my reality,” she had taken the decision to undergo the nine weeks of complex surgery required to have a double mastectomy, followed by reconstruction of the breasts with implants.

Since the surgery her chances of developing breast cancer have now dropped to under 5 percent, she said. She praised her partner, Brad Pitt, for his love and support throughout the procedure.

“Cancer is still a word that strikes fear into people’s hearts, producing a deep sense of powerlessness,” Jolie wrote. “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.”

Possible, yes. But for many women, unattainable, as Jolie acknowledged at the end of her essay.

“It has got to be a priority to ensure that more women can access gene testing and lifesaving preventive treatment, whatever their means and background, wherever they live.” The $3,000 tab for genetic testing alone, she noted, “remains an obstacle for many women.”

This is the heart of the matter.

Even if women can get the tests, many will be unable to take action. Unlike Jolie, most people do not live in a world where cost, even to save one’s life, is no object.

Insurance plans vary widely in what they cover, but in online discussion forums, women who have undergone the procedure say that even when insurance does kick in, they end up paying many thousands of dollars out of pocket to satisfy deductibles and other expenses.

My respect for Angelina Jolie grows all the time. She not only verbally encourages high risk women to seek out the information and medical experts who can help them make informed choices, but she shows by action that she can be strong and feminine.

But I think the next step for Jolie and others with means would be to donate money for funding these tests for women without health insurance who have these genetic mutations.

I was happy to find that The Pink Lotus Breast Center, which treated Jolie, does have a nonprofit arm that offers free screening, diagnosis, surgery and post-surgery treatment to women who are “uninsured, underprivileged and unable to pay for their own breast care.”

An even better solution: we need to stop fetishizing breasts in this culture.

Sarah T. Schwab is a Sunday OBSERVER contributor and Fredonia State graduate. Send comments to

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