Once again, Angelina Jolie Pitt is shining a bright spotlight on women’s health.
On March 24, Ms. Jolie Pitt wrote an op-ed piece for the New York Times in which she announced her decision to have a risk-reducing laparoscopic bilateral salpingo-oophorectomy (removal of her ovaries and fallopian tubes.) This is following her decision to undergo a preventive double mastectomy in 2013, after learning through genetic testing she carried a BRCA1 gene mutation.
As in 2013, Ms. Jolie Pitt has chosen to discuss her decision publically, bringing attention to an area of women’s health that is often not discussed. However, her decision may raise questions for some women about the choices she made and what might be right for them.
In the piece, Ms. Jolie Pitt notes that “I did not do this solely because I carry the BRCA1 gene mutation, and I want other women to hear this. A positive BRCA test does not mean a leap to surgery.” Ms. Jolie Pitt has both a BRCA genetic mutation and a strong family history of cancer, and she is past her childbearing years. Given her personal circumstances, her decision to undergo risk reducing surgery is in line with ACOG’s recommendations.
However, this surgery is not right for every woman. Women with BRCA mutations have many options for ovarian cancer prevention, including additional screening through blood tests and ultrasounds and taking combined hormonal birth control pills (those containing estrogen and progestin.) It’s important for women to talk to their doctor about the best management strategy for them.
And while genetic testing is a helpful tool, it is not right for every woman. BRCA gene mutations are rare; about 1 in 300 people carry a BRCA1 mutation, and 1 in 800 carry a BRCA2 mutation. While ACOG recommends routine evaluation of a patient’s risk for hereditary breast and ovarian cancer, genetic testing is recommended only for high-risk women. ACOG’s patient education fact sheet has more information on who should consider genetic testing.
Ms. Jolie Pitt has done a great public service by discussing her decision publically. Hopefully it will help women learn more about ovarian cancer and options to reduce their personal risk.