It was a decision she made with the support of her partner Brad Pitt because she didn't want her kids to live with the worry about whether their mom would be around as they grew up.
Angelina Jolie is a woman with means. She has the money for the BRCA test. She has the money for this type of extensive surgery. But I'm guessing that she would give back all her money if her kids could have their grandma around.
Genetic testing is a complicated issue for many women. There those who might want the test but are afraid because they don't want that information on their health insurance forms (even in the new world where you can't be denied health insurance for a pre-existing condition.) Once something goes on your forms who knows who else could find out about it -- maybe even potential employers.
Angelina Jolie is not naive and knows that breast cancer kills and there are many women out there who do not have access to the proper medical care.
Here are her words:
...I am writing about it now because I hope that other women can benefit from my experience. Cancer is still a word that strikes fear into people’s hearts, producing a deep sense of powerlessness. But today it is possible to find out through a blood test whether you are highly susceptible to breast and ovarian cancer, and then take action...
I choose not to keep my story private because there are many women who do not know that they might be living under the shadow of cancer. It is my hope that they, too, will be able to get gene tested, and that if they have a high risk they, too, will know that they have strong options.
There are not many women in Hollywood who could write an op-ed like this. But she has crafted for herself a very unique position. She is still the most sought after onscreen actress and since, as she says, you can't tell that she had surgery except for some small scars, I imagine this won't effect her on camera career at all.
I hope that this will allow her some piece of mind. She's continues to be a pretty impressive woman.