The surgery, like the double mastectomy Jolie underwent in 2013, was preventive. She carries a gene mutation called BRCA1 that puts her at high risk for breast and ovarian cancers, and three women in her family have died of cancer.
After a blood test revealed high levels of inflammatory markers that could be signs of early cancer, Jolie immediately underwent testing for a tumor. The surgeon who conducted the ultrasound was the same one who treated her mother, Jolie wrote, and the two teared up when they saw one another.
“But we smiled at each other and agreed we were there to deal with any problem, so ‘let’s get on with it,’ ” Jolie wrote.
The tests were negative, but Jolie opted for surgery anyway. Though there are several routes for preventing cancer in women with the BRCA1 mutation, Jolie and her doctors — both Eastern and Western — decided that removing her ovaries and tubes was best for her.
The surgery, called a laparoscopic bilateral salpingo-oophorectomy, effectively puts Jolie in early menopause. The 39-year-old will not be able to have any more children.
“But I feel at ease with whatever will come, not because I am strong but because this is a part of life,” she wrote.
For advocates of breast cancer awareness, Jolie’s essays are a welcome dose of candor on a subject they say is often stigmatized.
A few decades ago, “it would not have been the norm for someone of Angelina’s stature to come out and talk about having this disease, having preventive surgery like this,” Nancy Brinker, the founder of Susan G. Komen for the Cure, told The Washington Post in 2013. “It’s a real testimony to her and to the journey we’ve all gone on in the last 30 years.”
That sentiment was echoed on Twitter Tuesday morning:
A study published in the journal Breast Cancer Research last year found that referrals to breast cancer clinics more than doubled in the United Kingdom after Jolie wrote about her first round of surgery.
Jolie’s announcement “is likely to have had a bigger impact than other celebrity announcements, possibly due to her image as a glamorous and strong woman,” Gareth Evans, who led the study, told the BBC. “This may have lessened patients’ fears about a loss of sexual identity post-preventative surgery and encouraged those who had not previously engaged with health services to consider genetic testing.”
Many saw Jolie’s decision as a feminist victory as well — a rare declaration from someone widely considered a sex symbol that being a woman is about more than having the right body parts.
“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,” Jolie wrote in 2013.
This week’s essay echoes that sentiment: “I feel feminine, and grounded in the choices I am making for myself and my family,” she said.
“I most appreciate that the former Lara Croft, Tomb Raider refuses to equate breasts with femininity,” wrote New York Magazine’s Maureen O’Connor after Jolie’s mastectomy. “The implied message: You can be a normal woman without natural breasts. You can be a normal woman with no breasts at all.”
Unlike her 2013 opinion piece, which reveals almost no inner angst about her decision to have both breasts removed, Jolie’s most recent piece shows more uncertainty about her second round of surgery. For one thing, the removal of her ovaries has biological implications that the loss of her breasts did not.
But the piece lingers far longer on the medical details of her decision than the emotional ones. Jolie is almost clinical in her description of the steps leading up to her surgery, intent on sharing “any information that could be useful” with other women.
“I wanted other women at risk to know about the options,” she said at the beginning of her essay.
The piece concludes with the same sentiment.
“It is possible to take control and tackle head-on any health issue,” Jolie wrote. “You can seek advice, learn about the options and make choices that are right for you. Knowledge is power.”
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