A MOVING CONFESSION BY ANGELINA JOLIE

MY MOTHER fought cancer for almost a
decade and died at 56. 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.
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, but the truth is I
carry a “faulty” gene, BRCA1, which sharply
increases my risk of developing breast
cancer and ovarian cancer.
My doctors estimated that I had an 87
percent risk of breast cancer and a 50
percent risk of ovarian cancer, although the
risk is different in the case of each woman.
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, on average.
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. 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.
On April 27, I finished the three months of
medical procedures that the mastectomies
involved. During that time I have been able
to keep this private and to carry on with my
work.
But I am writing about it now because I
hope that other women can benefit from my
experience. 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.
My own process began on Feb. 2 with a
procedure known as a “nipple delay,” which
rules out disease in the breast ducts behind
the nipple and draws extra blood flow to
the area. This causes some pain and a lot of
bruising, but it increases the chance of
saving the nipple.
Two weeks later I had the major surgery,
where the breast tissue is removed and
temporary fillers are put in place. The
operation can take eight hours. You wake
up with drain tubes and expanders in your
breasts. 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.
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. 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.
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.
I am fortunate to have a partner, Brad Pitt,
who is so loving and supportive. So to
anyone who has a wife or girlfriend going
through this, know that you are a very
important part of the transition. Brad was at
the Pink Lotus Breast Center, where I was
treated, for every minute of the surgeries.
We managed to find moments to laugh
together. We knew this was the right thing
to do for our family and that it would bring
us closer. And it has.
For any woman reading this, I hope it helps
you to know you have options. I want to
encourage every woman, especially if you
have a family history of breast or ovarian
cancer, to seek out the information and
medical experts who can help you through
this aspect of your life, and to make your
own informed choices.
I acknowledge that there are many
wonderful holistic doctors working on
alternatives to surgery. My own regimen will
be posted in due course on the Web site of
the Pink Lotus Breast Center. I hope that this
will be helpful to other women.
Breast cancer alone kills some 458,000
people each year, according to the World
Health Organization, mainly in low- and
middle-income countries. 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
cost of testing for BRCA1 and BRCA2, at
more than $3,000 in the United States,
remains an obstacle for many women.
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. 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.