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Opening Arguments

Jolie's dilemma

Wow, tough call by Angelina Jolies:

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.

[. . .]

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.

[. . .]

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.

Such courage -- I think that's the right word -- is hard for a man to understand, because our strongest inclination is to ignore something and hope it goes away. Her decision to go public was equally praiseworthy. Don't know if I could have done that, either.

The odds she quotes make this seem like a fairly obvious call -- from 87 percent to under 5. What if the preventive mastectomy would have taken her odds from, say, 70 percent to 30 percent? Maybe not so easy.