Is Angelina Jolie’s double mastectomy the best option when you have the BRCA 1 genetic defect?

This is a complex issue. On the one hand, removing both breasts with simple mastectomies and reconstructions will probably reduce the chances of getting breast cancer in woman with this defect from somewhere between 50% and 80% to about 5%.  However, the timing of the occurrence of breast cancer may be many years down the road.  For instance, if you are 35 years old and have this defect, the chances of getting cancer by 70 may be very high, but the chances in the next 15 years are much less.  By doing frequent testing of the breasts using ultrasound or MRI there’s a high likelihood of finding the cancer when it is small, if it were to occur.  For a woman who has an MRI once a year and a breast ultrasound six months later, the chances of having invasive...