Jolie, who made the announcement last month, stopped at one point to hold the face of one fan overcome with tears, and took a photo with her.
Brad said of his fiancee: "She is doing great, it is business as usual, it is the next stage for us."
Asked how important it was to have her support at the premiere he said: "I've never not had support from her. I love her, it just brings you closer and makes you stronger."
World War Z stars Pitt as Gerry Lane, a UN employee in a frantic race across the globe to battle the zombie pandemic that is taking over the world.
The couple was joined on the red carpet in Leicester Square by Pitt's co-stars Mereille Enos, Daniella Kertesz and Ludi Boeken, director Marc Foster and producers Dede Gardner and Jeremy Kleiner.
Jolie opted to have the double mastectomy after finding out she carried a faulty gene, called BRCA1, which made her likelihood of developing breast cancer 87%. The operation cut that risk to just 5%.
The Salt actress's mother, Marcheline Bertrand, died of ovarian cancer, also associated with the gene, in 2007. Her aunt Debbie Martin died of breast cancer just a week ago and Jolie missed the funeral, which was today, to be at tonight's premiere.
World War Z is released on June 21.