Angelina Jolie's Decision - More Perspectives - NYTimes.com Re "My Medical Choice," by Angelina Jolie (Op-Ed, May 14): When tests revealed that Ms. Jolie had a mutated BRCA1 gene, which significantly increases the risk of breast and ovarian cancer, she chose removal of her healthy breasts with a double mastectomy and reconstructive surgery. After this brave procedure, there's still a small risk of breast cancer. Women have other options. The National Cancer Institute facts on BRCA risk indicate that mammography, magnetic resonance imaging and clinical breast exams enhance the possibility of early detection and treatment. In the last 50 years, the medical literature has demonstrated that early breast cancer treatment with combinations of lumpectomy, radiation and chemotherapy yield the same healthy survival rates as mastectomy. As always, the final decision is between a woman and her physician. The writer is a retired consultant for the Breast Cancer Fund. People in Angelina Jolie's unenviable position, with a terrifying medical test result, are often criticized for undergoing "unnecessary" major surgery while still disease-free and driving up the cost of insurance. The principal benefit is, of course, the dramatic reduction in cancer risk. However, the cost of cancer treatment is also avoided. In 2004, I received a diagnosis of breast cancer that had not spread, but that had a very aggressive molecular profile. I underwent one operation, a fairly standard treatment of eight rounds of chemotherapy and six weeks of daily radiation. I did not spend a single night in the hospital. Yet the total amount paid by my insurer for 10 months of treatment was nearly $250,000. The treatments can also be highly toxic and create additional health risks. Ms. Jolie eloquently explained the value of this choice to her family, but it is probably also a sensible choice from an insurance perspective, and, if so, should be available to everyone similarly situated. Angelina Jolie's courageous Op-Ed essay highlights that many women face serious obstacles when seeking genetic testing and preventive treatment for breast cancer. Some of the biggest hurdles to that access are patents controlled by a private company, Myriad Genetics, on the genes that Ms. Jolie had tested - BRCA1 and BRCA2. As long as Myriad holds these patents, it has the exclusive right to dictate the testing options for women facing life-changing medical decisions. That includes the prohibitive price of recommended comprehensive testing - now over $4,000 - and the availability of second opinions. We have challenged Myriad's patents on the BRCA genes before the Supreme Court and expect a decision in June. Every woman who needs this vital testing should have the security of knowing that patents will not stand in the way of understanding her own genetic risk. For more than 150 years, the Supreme Court has said that patents cannot be issued on laws or products of nature. For the health of women and men everywhere, these patents, and the many other patents on human genes that have been issued, should be invalidated. SANDRA PARK Senior Staff Attorney A.C.L.U. Women's Rights Project New York, May 14, 2013