I knew I was not brave enough. But did I really have a choice? It’s ironic how when you face your own mortality, your internal clock speeds up. The tick tock inside me was rapid fire because I had many breast cancer risk factors that were piling up that was going to force me to make a decision. I have an intimate history with breast cancer My mom had breast cancer when she was 44. I was 13 at the time, and the memories are vivid. Before she was ever diagnosed, she did not have any high risk factors. She never smoked. She had breast-fed her children. She was in good shape. And it was the smallest thing that even made her question things — she found a very tiny pimple on her breast. A pimple. The doctor wasn’t even going to remove it at first. But when he finally did they found out my mom had breast cancer. It was in the 1980s and I vividly recall watching her suffer through chemotherapy. I remember her being so sick. The vomiting. Lack of energy. Losing her hair. She didn’t really have a choice. My 44th birthday was coming up. Tick tock. My risk of breast cancer was increasing.
High density breast tissue: Because I had a family history I decided to take the prudent step by seeing a high-risk breast cancer doctor. On my first mammogram they noted that my breast density was very high. I was clearly going to be learning many new terms and their potential intimate meanings to me. She said that with my mother’s history and my density the chances of me getting breast cancer were going up. The doctor decided to try a fairly new procedure to measure my pre-cancerous cells. Mammograms went from uncomfortable to terrifying. I knew that mammograms are not as effective to detect cancer if you have high density in your breast tissue. I was learning many new things. And my risk of breast cancer was increasing, and my mind was busy. I had A LOT to consider.
Pre-cancerous cells: The doctor recommended I undergo a breast MRI every year. So every six months I had some kind of test — mammogram or a breast MRI (who knew?). And as each appointment popped up on the calendar, my fretting turned to outright worry. Maybe even dread. I worried the weeks before and even more so of course, after waiting for the results. I even worried about what the injected contrast dye was going to do to my “healthy” body, even though it felt irrational. But intuition, if you’re listening closely, has a way of being really honest with you. One year later I did a follow-up test for my pre-cancerous cells. And we discovered they had tripled. Now my intuition and my body were both speaking to me. Now I was learning that pre-cancerous cells don’t necessarily mean you will get cancer. Again, who knew? But in my case, it was clear that they were growing. My risk of breast cancer was increasing.
Chek1, Chek2, whatever it takes: My doctor then recommended that my mother have some genetic testing done to help determine the source of her cancer. My mother discovered that she had the Chek2 gene. Learning so much on this journey. This gene is not as aggressive as BRCA, but does significantly increase the odds for breast cancer and colon cancer. So I underwent my own genetic test. Easy test but again it was time to wait for results. Tick, tock, tick tock. I remember in October 2016 I was helping my four children pick out their Halloween pumpkins when my phone buzzed and I saw the caller ID for my doctor. The kids played as I took my husband’s hand and was told I have the Chek2 gene. Cancerous genes can make a person feel they are living with a time-bomb. Tick tock. Still I was told it may or may not even evolve to cancer. My risk of breast cancer was increasing.
Information about my risks: My risks were increasing. Each risk completely outside of my control. So I paused the internal clock. And I asked myself, “Am I really helpless?” I did have choices. I could continue with the monitoring. Nope, not the right option for me. Or I could control the next step and completely avoid the terror of breast cancer. I had choices! As I researched everything I could get my hands on (Boy was I learning), I heard an argument that preventive mastectomy is not brave, but is a fearful choice. I pondered that. Was I fearful? Uh, heck yes! I was very fearful! I don’t want cancer! That c-word in movies is scary. In real life, it’s petrifying! But having any kind of major surgery is very risky. I realized I would walk into the hospital as a healthy women and leave the hospital in bandages with part of my body no longer with me. Amputated. This was not a cosmetic boob job. If I chose this route, I was choosing to remove my breasts because of the risk of cancer. To be honest, I was frustrated with the lack of information available for those considering a prophylactic bilateral mastectomy. That’s what it was called. I was learning, even if there seemed to be a dearth of information. It was confusing to understand which information was relevant since I did not have breast cancer. The truth is -there just is not enough factual information available to those facing this choice. I hope that changes. Let me be very clear, I am so appreciative of the support those with cancer receive, like my mom. Cancer patients are truly facing a monster and need to be armed with knowledge that can literally mean the difference between life and death. I was facing a tough choice and could not find definitive directions — should I continue to monitor or go ahead with life changing surgery? Tick, tock. With what I could find, I discovered that non-nipple sparing Prophylactic bilateral mastectomy could reduce my chances of breast cancer to less than 2 percent. My risk of getting cancer without the surgery could not be quantified completely, but shot up to approximately 65 percent.
Support when needed: So I did what every person who is fortunate to have a supportive network of friends and family does. I relied upon my family and friends to help me navigate through the emotional aspects, as well as help me look at my options. My husband and I reflected on what the constant monitoring was doing to us physically and mentally. Tick, tock. My friends and I talked about how I approach decisions and my emphasis on doing what is best for my family. I know my priorities, my faith — and I know my character. And I was so scared. This was a life-changing decision, and ultimately it was really up to me. So I armed myself as much as possible with what information I could and rallied the amazing support of my friends. And even though the clock ticked, I’ll be honest, I anguished over this for almost a year. . . What was I going to do? Then one of my friends asked, “If there was a 65 percent chance of something good happening in your life, would you do it? My answer was yes! Then she added, “Then think of this as a choice for something good” I am very fortunate. I had choices I get to make a decision. I get to make a choice. And so I did.
Choices amongst the risk: On June 26, 2017, I underwent a bilateral prophylactic mastectomy. I’m happy to say I have greatly reduced my risk. My risk of breast cancer is now less than 2 percent. The surgery and reconstruction have gone extremely well. My family, especially my husband, has been so supportive, somehow making me feel even more beautiful despite the ugliness. The recovery has been slow. My four school-age children have been patient and kind. This was never an easy or obvious choice. But I want everyone to know that each woman who makes the smart choice to get preventive check ups has a choice to approach their risk of breast cancer. Whatever way it takes — beat this terrible thing we call cancer. It’s breast cancer awareness month, and I look forward to picking out pumpkins again with my family, with a lot less worry in my mind. I greatly admire the strength of those women who have fought the battle of breast cancer. They are fighting so hard and should get the respect they most certainly deserve. I admire my mom and the fight that she won! During this month, I am also grateful for those that have struggled with their choices on how to reduce the risk of breast cancer. Their fight is completely different but still a foe. It can be a mental struggle filled with worries, but we are fortunate to have choices. I am a proud previvor and I have reduced my risk of breast cancer. And I hope my story can help others.