Hollywood actress Angelina Jolie has undergone a double mastectomy to reduce her chances of getting breast cancer.
The 37-year-old mother of six has explained her reasons for having the surgery in the New York Times.
She said her doctors estimated she had an 87% risk of breast cancer and a 50% risk of ovarian cancer. "I decided to be proactive and to minimise the risk as much I could," she wrote.
Her partner, Brad Pitt, praised her choice as "absolutely heroic".
Ms Jolie said the process began in February and was completed by the end of April.
In an article entitled My Medical Choice, she explained that her mother fought cancer for nearly a decade and died at the age of 56.
About one in five women diagnosed
with breast cancer will have a
significant family history of the disease
Having close family members - first
degree relatives like a sister, mother,
aunt or uncle - with breast cancer raises
a woman's own risk of the disease
Certain genes such as BRCA1
and BRCA2 are strongly linked with
breast cancer and can be detected with
Women carrying the BRCA1 mutation
have up to a 65% chance of developing
breast cancer by the time they are 70
Fewer than 1% of women are at high risk
of developing breast cancer
Another 2% of women deemed to be at
moderate risk might also benefit from
taking preventive breast cancer drugs for
five years, say experts
She said she had sought to reassure her children that the same illness would not take her away from them, "but the truth is I carry a 'faulty' gene, BRCA1, which sharply increases my risk of developing breast cancer and ovarian cancer".
She said that once she "knew that this was my reality", she had taken the decision to undergo the nine weeks of complex surgery required to have a double mastectomy, followed by reconstruction of the breasts with implants.
"There have been many advances in this procedure in the last few years, and the results can be beautiful," she wrote.
Her chances of developing breast cancer have now dropped from 87% to under 5%, she said.
She praised her partner, actor Brad Pitt, for his love and support throughout the procedure, and said she was reassured that her children had found nothing in the results "that makes them uncomfortable".
"I feel empowered that I made a strong choice that in no way diminishes my femininity," she said.
"For any woman reading this, I hope it helps you to know you have options," Ms Jolie went on to say.
"I want to encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices."
In an interview with the Evening Standard, Brad Pitt said: "Having witnessed this decision firsthand, I find Angie's choice, as well as so many others like her, absolutely heroic.
"All I want for is for her to have a long and healthy life, with myself and our children. This is a happy day for our family."
Ms Jolie, an award-winning actress and director, is also a long-time supporter of humanitarian causes. She is currently a special envoy for the UN Refugee Agency.
During the period she was undergoing the double mastectomy procedure, Ms Jolie visited the Democratic Republic of Congo with UK Foreign Secretary William Hague and attended the G8 summit of foreign ministers in London to raise awareness over sexual violence in conflict.
Born in 1975 to actors Jon Voight
and Marcheline Bertrand
Has spoken of a troubled childhood,
in which she self-harmed and took drugs
Won an Oscar for best-supporting
actress in 2000
Has visited conflict zones and raised
awareness of refugees and sexual violence
Granted honorary citizenship of Sarajevo for
2011 film about Bosnian war
Has three adopted children and three
biological children with partner Brad Pitt
She also helped launch a charity to fund girls' education set up by the Pakistani schoolgirl activist Malala Yousafzai, who survived being shot by the Taliban last October.
Ms Jolie has three biological children and three adopted children.
Emma Parlons, a 38-year-old mother from London who had the operation three years ago, welcomed her decision to raise awareness of the issue.
Ms Parlons said her risk of getting breast cancer was the same as the actress's. "If somebody said your flight across the Atlantic was 86% likely to come down, you wouldn't get on that plane would you?" she said in an explanation of her reasons for having the operation.
Professor Gareth Evans, of the Manchester Breast Centre in Britain, said the two genes BRCA1 and BRCA2 (breast cancer one and two) "were the first two majorly breast cancer pre-disposing genes that were identified" and are also linked to an increased risk of ovarian cancer.
"The risk associated with the genes isn't simply an exact figure like 87%," he told the BBC.
"It does depend on other risk factors, and so the risk for someone with a BRCA1 mutation could vary anywhere between 50 and 95% for breast cancer."
Currently, women facing a strong likelihood of developing breast cancer have only two real options - to have both of their breasts removed (a double mastectomy) or hope that it will never actually happen.
In January, the drugs watchdog in England and Wales, the National Institute for Health and Clinical Excellence, recommended women at a high genetic risk of breast cancer should be given the option of taking the drug Tamoxifen, or another one called raloxifene, for five years to cut their lifetime risk of the disease.