Jolie puts spotlight on difficult mastectomy choice for at-risk women

(CBS News) Thousands of women in this country have a genetic makeup that puts them at very high risk of developing breast cancer, and they face a very difficult decision.

Actress Angelina Jolie brought those women into the spotlight when she went public about her own struggle in an op-ed piece in The New York Times

Jolie says doctors estimated her risk of developing breast cancer was 87 percent. That's because she inherited a mutation of a gene called BRCA1, which increases the risk of both breast and ovarian cancer. Her mother, Marcheline Bertrand, died from ovarian cancer in 2007 at the age of 56. Jolie talked about her mother with Bob Simon on "60 Minutes."

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"My mother was a was a full-time mother," Jolie said. "She didn't have much of her own career, her own life, her own experiences, her own -- you know, everything was for her children."

"And do you try to be the same kind of mom that she was?" Simon asked.

"I will never be as good a mother as she was," Jolie responded.

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The 37-year-old actress made the difficult decision to undergo a double mastectomy before cancer could develop.

On February 2, Jolie secretly underwent a procedure that allows the nipple to be saved. It was separated from the underlying breast tissue but left connected to the skin so it could continue to get blood supply. Then, two weeks later, Jolie had a double mastectomy, with removal of all her breast tissue. Temporary fillers were put in place and over nine weeks, gradually expanded with fluid. Then she underwent breast reconstruction with implants.

Watch: Is a preventative mastectomy for you?

Dr. Patrick Borgen says this procedure dramatically improves the cosmetic result.

"It preserves the cosmetic appearance of the breast," he said. "In fact if it's done well, and I'm sure it was, it actually makes it difficult for someone to tell that a mastectomy has been done."

Judith Gomberg, 61, said she knew she had the BRCA1 mutation for six years before finally getting surgery. "I was living in the shadow of cancer," she said.
Judith Gomberg CBS News

Judith Gomberg, 61, knew she had the BRCA1 mutation for six years before finally undergoing surgery in 2010.

"I was living in the shadow of cancer. I knew that it was not a matter of if -- it was "when."

Gomberg said she had no second thoughts about her decision. "Whatever is going to happen is going to happen, but I took care of what I could," she said.

As for Angelina Jolie, doctors told her that her risk of breast cancer fell from 87 percent to less than 5 percent. She knows she also has a 50 percent chance of ovarian cancer, but said she decided to take care of the breast cancer risk first.

  • Jonathan LaPook

    Dr. Jonathan LaPook is the chief medical correspondent for the CBS Evening News. Follow him on Twitter at @DrLaPook