When Angelina Jolie announced that she had chosen to have a preventative double mastectomy it caused a debate far wider than many may have predicted.

On the one hand, you read about how brave and smart she was to do this, since as a carrier of BRCA1 (the “breast cancer gene”) her risk of developing breast cancer after the surgery was reduced from 87% to 5%.

Others are not so positive. Some in the field of natural health have written that Jolie is teaching young women that to have a long life they have to maim their bodies, rather than eat right and live a healthy lifestyle. Still others have written that her choice was political, since it coincided with a for-profit corporate P.R. campaign lobbying the U.S. Supreme Court decision on the BRCA1 patent. What’s true?

Wow. Well-informed brave decision or poor role modeling that’s all about money? Pretty extreme options.

Ok, I’m in no way neutral on this topic. My sister Beth died of breast cancer 10 years ago, and my life has never been the same. Those of us who loved her watched her endure three years of chemotherapy fighting the disease, until she finally came to terms with losing that fight to die peacefully, surrounded on all sides by her family. My big sister taught me lessons that I still learn from, lessons that ultimately helped me to change my own life.

Beth is the closest person I have lost, but there have been others — more than I care to count. I also love many survivors, and have had three scary biopsies of my own. So I have strong feelings about the topic of breast cancer, especially in the area of prevention and treatment. Back to the question… mammo or no?

Currently, mammography is the most widely known option available to women. But it’s not prevention of breast cancer, it’s early detection. You don’t die of a tumor in your breast – you die because it spreads to your liver, your bones, your brain. Western medicine argues that the sooner you find the tumor and take it out, the better your chances are of preventing its spread. Women are urged to get annual mammograms starting at the age of 40 or 50, or to get them semi-annually, or to go with an MRI…. Controversy about the procedure is everywhere.

A report published ten years ago showed that mammograms did not decrease the rate of death from breast cancer. Cancer experts from around the world condemned this report, but the researchers stuck to their conclusion that mammograms don’t decrease the numbers of women who die of the disease. More recently there has been new research that suggests that the number of early detections has not changed since mammograms became popular. Other experts have challenged that report and argue that mammography is lifesaving because of early detection. The American Cancer Society and the National Cancer Institute stand strong in their support of the test.

So… mammo or no? How often? Gene test?

The news about Angelina Jolie may have led many more women to get tested for the “breast cancer gene” (one option if you can afford it), which gives you more information about your risk even as it raises a lot more questions about your choices —  surgery or no?

Is taking every medical test Western medicine has to offer the right way to go? Or is it better to simply live the healthiest life you can, keep your weight down, don’t smoke, don’t drink to excess, meditate and have joy in your life?

I’m not a scientist, and even they can’t agree. I have no idea what’s right for anyone else, just for me. My choice is to try my best to make healthy decisions every day. My sisters and I (six of us!) are all participating in The Sister Study (see www.thesisterstudy.org ) in support of studying the disease. I donate to cancer-related organizations and participate in the Race for the Cure. I alternate between mammograms and breast MRIs – supposedly less toxic to the breast.

After my third biopsy I told my radiologist, “No more. This can’t be good for my breast.” Since then I haven’t had any more suspicious findings but I can’t honestly say what I’ll do if another mammogram sets off alarms for my radiologist. I remember my sister saying that all she wanted was to see her kids graduate from high school. She didn’t get her wish. My son is only 15 and I want to see him through a lot more than high school. If it comes right down to it, what would I be willing to do to try to make that happen? What would you do?