Two years ago, actress Angelina Jolie revealed she had undergone a double masectomy as a preventative measure against breast cancer, for which she had an extremely high risk factor.

Now the actress, who has three adopted children and three biological children with her husband Brad Pitt, has opened up about the second invasive surgery she recently had to remove her fallopian tubes and ovaries.

The decision came when Angelina's doctor told her that her annual cancer screen showed "inflammatory markers" which could be a sign of early ovarian cancer, she explained in a New York Times opinion piece. The actress' own mother died of ovarian cancer after being diagnosed aged 49. 

"I went through what I imagine thousands of other women have felt. I told myself to stay calm, to be strong, and that I had no reason to think I wouldn’t live to see my children grow up and to meet my grandchildren," Angelina said.

"I called my husband in France, who was on a plane within hours. The beautiful thing about such moments in life is that there is so much clarity. You know what you live for and what matters. It is polarising, and it is peaceful."

Although a second round of test results five days later showed that the 39-year-old actress was still cancer-free, she decided to undergo the surgery anyway to fully remove the risk.

"To my relief, I still had the option of removing my ovaries and fallopian tubes and I chose to do it," she said, making sure to let women know that there are other options too. "I feel deeply for women for whom this moment comes very early in life, before they have had their children," she admitted. 

"Their situation is far harder than mine. I inquired and found out that there are options for women to remove their fallopian tubes but keep their ovaries, and so retain the ability to bear children and not go into menopause. I hope they can be aware of that."

Whatever the outcome, Angelina says she is content in her decision. "I will not be able to have any more children, and I expect some physical changes. But I feel at ease with whatever will come, not because I am strong but because this is a part of life. It is nothing to be feared."

What a brave move to speak out about such a difficult choice – well done Angelina.