( CNN ) -- Angelina Jolie stunned many people with an op-ed Tuesday describing her reasons for choosing to have a preventive double mastectomy . Her mother passed away at the age of 56 after battling ovarian cancer . Moreover , Jolie found that she had the BRCA1 gene , which significantly increases the lifetime risk of breast cancer . In fact , she reports that her doctors estimated that she had an 87 % chance of developing breast cancer . I have no doubt that this piece is causing many women across the country to think about their own health and chances of developing the disease . Thanks to many successful organizations , breast cancer awareness is at an all-time high in the United States . A person of Jolie 's stature publicly discussing such a personal and difficult decision will likely weigh on the minds of many women who have similar concerns . Breast cancer is a real disease , it 's not rare , and it can potentially strike almost anyone . I have no doubt that her op-ed in The New York Times will help many women who would not have considered this procedure to do so now . Five reasons we love Angelina Jolie . In one sense , that is a good thing . There are legitimate and real reasons for some women to consider a preventive , or prophylactic , mastectomy . Some women who have had breast cancer in one breast elect to have a mastectomy of the other breast to prevent the cancer from spreading there . Some women who have a family history of cancer , especially before age 50 , might consider the procedure . More recently , women who have been able to learn through genetic testing that they have the BRCA1 or BRCA2 gene , both of which make it more likely that they might develop cancer , have been given new information that may help them make a decision . It 's a personal decision . It 's also a serious one , because there are downsides to a preventive mastectomy as well . First of all , it 's still a major procedure , and it carries all the risks of one ; one should never minimize the risks of a big operation . It 's also irreversible , and some women do suffer psychological or physical consequences afterward . No one should ever judge another woman 's decision in this area , but it would serve individual patients poorly for doctors not to discuss with them both the potential harms as well as benefits . Opinion : Angelina Jolie 's brave message . It 's also important to recognize that even a preventive mastectomy is not a guarantee against cancer . Studies show that it 's about 90 % effective in preventing breast cancer in moderate and high-risk women . That still leaves a 10 % chance of developing cancer in the chest wall , armpit or even in the abdomen . That 's because it 's pretty much impossible for even the best surgeon to remove all breast tissue from a woman . Because of this , some women choose not to have the procedure done , even when they are at high risk . Just a few weeks ago , Peggy Orenstein wrote a compelling account of her decision not to undergo the procedure after her first brush with breast cancer . Her reasons are just as valid and important as Jolie 's but may not make the same splash in our national discussion . Part of the reason for that is that there are few stars with Jolie 's fame who could claim this sort of attention . But there 's a larger current here that is worth considering . We in America sometimes are risk averse . We favor trying to reduce the chance of something bad happening to as close to zero as possible . We also tend to err on the side of doing something rather than nothing . There 's nothing inherently wrong with this type of behavior . But we should recognize it . My preventive mastectomy : Staying alive for my kids . We tend to screen more than other countries . We tend to push for more invasive and technologically driven solutions . We do these things , sometimes , at the expense of both health and money . In the last few years , there has been some pushback against the potential over-use ( and detriment ) of mammograms and prostate specific antigen tests . Such debates are controversial but important . You ca n't reduce risk to nothing . Trying to do so will lead to practices none of us would support . After all , someone could make the argument that we should remove all breast tissue from all women because you never know where breast cancer will strike . That 's hyperbolic , and no one is suggesting it , but it shows that this is really a personal , and individual decision . That 's how it should be . Jolie 's relating her decision to have a preventive mastectomy is no more or less brave than Orenstein 's decision not to have one . But both are welcome in their bringing to the forefront that these are discussions that every woman should have with their physicians , their loved ones and themselves . The opinions expressed in this commentary are solely those of Aaron E. Carroll .
Aaron Carroll : Jolie op-ed on elective double mastectomy was brave , raised consciousness . Women have more info today to make such a decision , but it also has downsides , he says . Comment: Carroll : Jolie 's decision was brave , but Orenstein 's was , too .