ANGELINA JOLIE has shriv­eled to 92 pounds, sources say, and fiancé BRAD PITT is terrified that if she has sur­gery to remove her ovaries, she’ll die!

After the 38-year-old actress under­went a preventative double mastectomy and breast reconstruction, Brad put on a brave face to the world and for the sake of their six children.

But insiders tell The ENQUIRER that behind the scenes the actor is a bas­ket case – studying medical research that shows the surgery increases Angie’s risk of heart disease, osteoporosis and, ironically, cancer, and it can lead to pre­mature death.

“This is Brad’s worst night­mare,” said a source close to the couple, adding that Angelina’s worka­holic ways could also contribute to health woes.

“Angelina’s been working nonstop on a film project and human­itarian causes for the United Nations, and it’s taken a serious toll on her.

“She weighs less than she did when she was 16, and Brad’s afraid that when it’s time to have her ovaries re­moved, she won’t be strong enough. He’s worried sick that she could die!”

Angelina recently revealed she’d undergone the double mastecto­my after learning she carries the faulty BRCA1 gene that sharply increases her risk of developing both breast and ovar­ian cancer. Her mother, Marcheline Bertrand, died of ovarian cancer, and sources say Angelina plans to have her ovaries surgically removed. But medi­cal experts warn it carries serious risks.

Dr. Mary Jane Minkin, clinical pro­fessor of obstetrics and gynecology at Yale University School of Medicine, told The ENQUIRER: “At our BRAC clinic at Yale, we recommend removing the ovaries and taking estrogen replace­ment therapy. Women who have their ovaries removed and don’t take estro­gen are at significant increased risk of heart disease, osteoporosis and demen­tia, as well as premature death.”

But the hormone replacement thera­py carries serious risks as well.

“Taking an estrogen supplement alone leads to a higher risk of uterine cancer,” Dr. Herman Kattlove, a Los Angeles-based oncologist and former spokesperson for the American Cancer Society, told The ENQUIRER.

“If progesterone is given along with the estrogen, the risk of uterine cancer is avoided, but there is a higher risk of breast cancer.”

With all those issues to consider, “Brad believes the surgery to remove Angelina’s ovaries is a double-edged sword,” noted the source.

Adding to Brad’s worries, Angelina is keeping a hectic schedule despite drop­ping so much weight.

As The ENQUIRER has reported, the Oscar-winning actress collapsed during a mission to war-torn Africa in March.

When she confessed what had hap­pened to Brad, “he warned her, ‘You’ve got to slow down. You’re killing your­self,’” said an insider.

“He reminded her that her own kids need her, and he doesn’t want them growing up motherless.”

Despite that, the “Salt” beauty has been busier than ever.

Angelina joined Brad at the London  premiere of his blockbuster “World War Z” on June 2 and at the Paris premiere the next day.

On June 20, she visited a Syrian ref­ugee camp in Jordan to mark World Refugee Day, and later she participated in a news conference there.

On June 24, she attended a United Nations Security Council meeting in New York City and later dropped by a Toys “R” Us in Manhattan with son Pax. Then, she flew back to L.A.

“In between all this, Angie has also started working on ‘Unbroken,’ a movie she’s directing,” said the insider.

“Believe it or not, she still had draining tubes sticking out of her chest after the double mastectomy while she worked on the storyboards in L.A.

“Brad has begged Angie to slow down and gain weight so she will be ready for the surgery.

“But she won’t listen – and he believes it could kill her!”