Angelina Jolie's Double Mastectomy Fueling National Debate

June 4, 2013— -- Angelina Jolie says she has no regrets about going public with her very private decision to have a preemptive double-mastectomy to slash her risk of developing breast cancer.

"I'm very happy to see the discussion about women's health expanded. That means the world to me," Jolie told "Good Morning America" Sunday as she walked the red carpet with boyfriend Brad Pitt at the London premiere of his new film, "World War Z."

Angelina Jolie: 'Really Grateful for All the Support'

This was the actress' first public appearance since penning a New York Times essay explaining how she had both breasts removed after being diagnosed with a rare mutation of the BRCA gene that put her risk of developing breast cancer at nearly 90 percent.

In revealing her medical choices to the world, experts say she instantly created global awareness for genetic screening and preemptive medical procedures.

Dr. Michael Cowher, a breast cancer surgeon with the Cleveland Clinic, said the hospital's breast services clinic has not been tracking exact statistics but there has been a noticeable increase in patient inquiries about BRCA screening.

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"Personally, I haven't had a new patient who hasn't asked about genetic testing in the past few weeks since Jolie's announcement," he said.

Dr. Laura Corio, an OB-GYN at Mt. Sinai in New York City, agreed.

"We've been offering genetic testing for a while but now patients are asking for it more often and when they do, they seem more informed about their choices," she noted.

While the experts generally agree that Jolie has handled herself admirably and has provided valuable information to the public, they worry there is also a downside to her revelations.

According to the American Cancer Society, a case like Jolie's is relatively rare. Only about 5 percent of breast cancer cases can be linked to a faulty BRCA gene.

Jolie's Double Mastectomy Not Always a Lifesaver

"Not every woman needs to be tested and not every woman who tests positive for a BRCA gene mutation should have a double mastectomy," said Dr. Otis Brawley, chief medical officer for the American Cancer Society. "My concern is that not everyone reading what she wrote will understand this."

According to Brawley, only women with a strong family history of breast cancer where close relatives have been diagnosed with the disease at a young age are good candidates for genetic testing. Jolie lost her mother and her aunt to breast cancer.

"I think we need to do a careful job explaining who should and who shouldn't be tested," Cowher said. "I've had several patients who have asked to be tested and who have not met criteria, to their dismay."

Dr. Sandhya Pruthi, a consultant in the breast diagnostic and high risk breast clinic at the Mayo Clinic in Rochester, Minn., said that even a woman who undergoes genetic testing might not get the answers she is looking for.

"If they don't test positive this might lead to a false reassurance that they have nothing to worry about when they could be positive for some other genetic mutation we don't know about yet," she said. "Or testing positive for a mutation with unknown significance can create even more uncertainty and anxiety."

Pruthi said women who do test positive for a high-risk BRCA gene might be able to lobby for better health insurance coverage for mammograms and other surveillance tests, but might also have a harder time getting life insurance.

Testing is costly and, in many cases, not covered by insurance, even for women in the high-risk category. Women interested in testing should speak with a genetic counselor, Brawley advised.

And if they do test positive for a dangerous genetic mutation, they might want to weigh the risks of surgery against other possible preemptive alternatives such as more aggressive screening or medication.

"Mastectomy isn't the only option and is certainly not the right option for everyone," he said.

Brawley said that for the typical women, regular mammography screening is the best way to monitor breast-cancer risk. For women with no family history and who don't have other factors increasing their risk of developing breast cancer, the American Cancer Society recommends a yearly mammogram starting at age 40. Other groups, such as the U.S. Preventive Services Task Force, advise women to begin screening at age 50 and repeat the test every two years.

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Join Dr. Richard Besser, ABC News chief health and medical correspondent, for a tweet chat today at 1 p.m., ET on breast cancer prevention.

While only a fraction of breast-cancer cases are linked to genetic mutations -- as was the case with Jolie -- there are many other risk factors associated with breast cancer, including age, environment and lifestyle. Our experts will discuss how you can find out what your risk factors are and take what steps you can take to lower your chances of developing the disease.

Besser will be joined by doctors from top hospitals all over the country as well as medical experts from the Centers for Disease Control and Prevention, The American Cancer Society and various chapters of the Susan G. Komen Breast Cancer Foundation.

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