Angelina Jolie once played the fearless action hero of the Tomb Raider movies, said Elizabeth Weitzman in the New York Daily News. But last week, she showed “what a hero really is.” The actress revealed to the world that she had undergone preventive double mastectomy surgery, after learning she carries a gene mutation giving her an 87 percent chance of developing breast cancer. Once named “the most beautiful woman in the world,” Jolie has not only sparked a national conversation about breast cancer prevention, but directly challenged the idea that she—or any woman—is defined by her breasts. Jolie said she was happy with her breast reconstruction, and felt “empowered that I made a strong choice that in no way diminishes my femininity.”

Jolie deserves full credit for publicly explaining her decision, said Peggy Orenstein in NYTimes.com, but many doctors worry it will actually “add fuel to a culture of fear” around breast cancer. Less than 1 percent of women share Jolie’s gene mutation, and most women never need to consider such a radical procedure. Yet preventive double mastectomies among women who’ve shown some signs of cancer in one breast have shot up 188 percent in the last 15 years, even though the risk of getting cancer in the other breast is small—about 5 percent. Having had a double mastectomy and reconstruction myself, let me tell you it’s “a huge ordeal,” and it’s a step no one should take unless it’s medically necessary.

Who defines what is necessary? asked Melinda Henneberger in WashingtonPost.com. If a woman has an elevated risk of breast cancer, or has already had cancer in one breast, it’s up to her—not a doctor’s probability chart—to decide whether to remove both breasts. Jolie said she made her decision so she’d be around for her children, her partner, Brad, and other loved ones. All the women I know who’ve had double mastectomies—including me and my mother—have had the same reason. Whether you have an elevated genetic risk, or have already had breast cancer, the decision to trade your breasts for a greater chance of living into old age is “a no-brainer.”

Perhaps it’s a no-brainer for those who can afford it, said Deborah Johnstone in Salon.com, but many women cannot. Jolie’s gene test cost $3,000, and her reconstruction tens of thousands—not to mention months away from work. Some health insurance policies do not cover these costs. The sad reality is that “many women in America simply cannot afford to be sick,” let alone spend a small fortune to prevent being sick.

But that’s hardly Angelina Jolie’s fault, said E.J. Graff in Prospect.org. In the short time since she made her announcement, we’ve discovered that her breasts “are a Rorschach test,” inspiring some women to admire her courage, and others to resent her decision, her wealth, or her celebrity. To me, the bottom line is this: “One of the world’s most famous sex symbols has effectively rolled her eyes at the idea that breasts equal femininity.” How can you not admire that, said Maureen O’Connor in NYMag.com, especially since her breasts were once considered the Hollywood ideal? In her announcement, Jolie took pains to reassure other women facing cancer or mastectomies, saying that her surgery did not make her “feel any less of a woman.” That’s a powerful—even revolutionary—message in a country that is “simultaneously breast-obsessed and among the more breast-cancer-afflicted nations in the world.”