Angelina Jolie has revealed that she has undergone a preventive double mastectomy to reduce her risk of contracting breast cancer.
Jolie said on Tuesday she was speaking out to encourage other women with a family history of cancer - her mother died of it age 56 - to seek out information from doctors and make informed choices about their bodies.
She said she managed to keep the issue quiet and keep working. "But I am writing about it now because I hope that other women can benefit from my experience," she said.
The 37-year-old American actress wrote in an opinion piece entitled "My Medical Choice" in The New York Times that she had chosen the procedure because she carries a faulty gene that increases her risk of both breast and ovarian cancer.
Jolie, one of Hollywood's best-known faces and the partner of actor Brad Pitt, said that because of this gene, known as BRCA1, her doctors estimated she had an 87 percent risk of breast cancer and 50 percent risk of ovarian cancer.
"Once I knew that this was my reality, I decided to be proactive and to minimize the risk as much I could. I made a decision to have a preventive double mastectomy," she wrote.
On a personal note, I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity
"I started with the breasts, as my risk of breast cancer is higher than my risk of ovarian cancer, and the surgery is more complex," Jolie wrote.
She said that on April 27 she completed the three months of medical procedures that the mastectomies involved.
Jolie said her chances of developing breast cancer are now down to five percent.
Jolie and Pitt have three adopted and three biological children.
"I can tell my children they don't need to fear they will lose me to breast cancer," Jolie said.
Jolie described a two-stage surgical process, the second of which is an operation that can take up to eight hours as the breast tissue is removed and temporary fillers are put in place.
"You wake up with drain tubes and expanders in your breasts. It does feel like a scene out of a science fiction film. But days after surgery you can be back to a normal life," Jolie wrote.
"On a personal note, I do not feel any less of a woman. I feel empowered that I made a strong choice that in no way diminishes my femininity."
Jolie, one of the world's highest paid performers, said the cost of getting tested for BRCA1 and another faulty gene, called BRCA2, is more than $3,000 in the United States and that this "remains an obstacle for many women".
She said she hopes women living under the threat of cancer will be able to get tested.
"Life comes with many challenges. The ones that should not scare us are the ones we can take on and take control of," Jolie wrote.
British Foreign Secretary William Hague, who has been working with Jolie in the past few months in her role as UN special envoy for refugee issues to highlight the problem of sexual violence in conflict, said she was a "brave lady and will be an inspiration to many".
Hague and Jolie visited Rwanda and Democratic Republic of Congo in March and successfully joined forces at a meeting of G8 finance ministers last month to win a pledge to act against the use of rape as a weapon of war.
"She's a courageous lady, a very professional lady. She's done a lot of work with me in recent months and travelled with me through some difficult places in the Congo," Hague told Sky News television.
"She gave no sign that she was undergoing such treatment. She's a very brave lady not only to carry on with her work so well during such treatment, also to write about it now and talk about it. She's a brave lady and will be an inspiration to many."