Mastectomies have been in the news a lot recently, since actress Angelina Jolie revealed in an op-ed that she wrote for the New York Times that she had recently undergone the procedure. With the growing awareness of breast cancer among today’s society, mastectomies are becoming a more popular option for women who carry a high risk of developing this disease. Mastectomy refers to a surgical procedure that either partially or fully removes one or both breasts. It’s most commonly associated with breast cancer, and while it is usually done to treat the disease, it is now being done prophylactically, or as a preventative measure. One of the main reasons women feel more comfortable having preventative mastectomies is because of the reconstructive options available today.

Breast cancer is a very real threat to millions of women, and some are at a higher risk due to genetic predisposition, which are more likely to develop this form of cancer. In Angelina Jolie’s case, she carries BRCA1, a gene, which puts her at up to a 65% chance of developing breast cancer at some point in her life.

Angelina Jolie’s mother fought the disease for nearly a decade, before losing her battle with cancer at age 56. In her op-ed, Jolie explains that while this was a very difficult decision for her to make, she decided to undergo surgery in order to be there for her children, and ensure that she would live long enough to meet her grandchildren.

The Angelina Jolie mastectomy process began on February 2nd, with a procedure known as “nipple delay”. Nipple delay ensures that the disease won’t develop in the breast ducts behind the nipples, and increases the blood flow to this area. Although somewhat painful, this part of the process increases the chances of preserving a woman’s natural nipples.

After two weeks, Jolie had the bilateral mastectomies and the first stage of immediate reconstruction, which removed her breast tissue, and had tissue expanders (balloons filled with saline) put in place temporarily to stretch the skin gradually over the next 9 weeks. This surgery she says took eight hours.

Nine weeks after the removal of the breasts, Jolie underwent second stage breast reconstruction, with removal of the tissue expanders and placement of permanent implants. As Angelina Jolie explains in this section of her op-ed, there have been numerous advancements to breast reconstruction over the past several years, and “the results can be beautiful”. After completing the surgery, Jolie now only carries up to a 5% chance of developing breast cancer.

Breast reconstruction is mandated by federal law to not only be offered, but covered by health insurance companies for all women diagnosed with breast cancer and/or the cancer gene BRCA. The type of reconstruction Jolie had is the most common (85%), with several staged surgeries including tissue expanders and later implants. The type of reconstruction one chooses has many factors including the need for radiation therapy or not, and the ability to use ones own tissue (belly) to make a new breast out of.

Angelina Jolie’s choice to bring her mastectomy to light in this op-ed is an important one. As Jolie explains, the decision to have a mastectomy is not easy. Many women simply don’t know how likely they are to develop the disease until it has already started to grow. It’s highly important that women know their risk of disease so that they can take measures to prevent it. As breast reconstruction has come a long way in recent years, mastectomy is now a more attractive option than it has ever been before and more women are choosing to have the entire breast removed and reconstructed rather than trying to preserve the breast with a lumpectomy.