Well done Jolie.

Foreign news providers are buzzing after Angelina Jolie wrote an article in the New York Times to announce that she had both her breasts removed earlier this year to prevent cancer. Her partner, Brad Pitt was present throughout. She says that she took this drastic step because she is determined to stay alive for her children. The only response to this news is " wow ". Jolie is an actress renowned for  her beauty and for her to risk such a mutilating operation must have taken exceptional courage. Mastectomy is a very old procedure and the incision is made under the breast so it cannot be seen even when the woman is not wearing anything. The breast tissue would have been replaced by a prosthesis of similar size so no one will be able to make out any difference in her appearance. Whether there is any psychological effect only time will tell. A lot will depend on how people in the west react to her new reality and whether her career stays the same or starts to wane. Western people are obsessed with breasts and anyone watching the Oscars will have noticed how much attention is paid to the cleavage of female celebrities. Paparazzi follow famous women day and night hoping to capture one instance of " wardrobe malfunction " which they can then sell for high prices. On 1 February 2004 during the Superbowl halftime show Justine Timberlake exposed one of Janet Jackson's breasts causing a huge furore in the US. Jackson had to apologise for her indiscretion. To get their pictures in papers women wear dresses as revealing as possible so the occasional accident is possible, the commonest is a glimpse of the areola surrounding the nipple, called a " nipple slip ". We can imagine the interest of all photographers to Angelina Jolie's breasts from now on. Having been in the limelight for so long she is well equipped to handle all that attention but she will have to get used to being in the center of controversy. Her mother she was close to died of ovarian cancer at the age of 56 years. Angelina Jolie carries a mutation on the BRCA 1 gene which gave her an 87% chance of breast cancer and a 50% chance of ovarian cancer. The higher possibility of cancer of the breast and the relative ease of operation caused her to have both of them removed and thus reduce that probability to near 0%. Whether she decides to get her ovaries removed as well remains to be seen. Apart from cosmetic significance removal of breast has no systemic effect but removal of ovaries will precipitate menopause immediately with increased risk of heart disease and osteoporosis in future. Trouble is women with cancer but without the dangerous mutation still insist on removal of the normal breast when a simple lump removal is enough. This not only causes unnecessary trauma but hugely increases costs. How many women in India maybe carrying dangerous mutations but are completely unaware? How long will we remain third world?