One of the cover stories in this month’s O: The Oprah Magazine is about a woman whose family has a very strong history of breast cancer and she decides, after several years of going through the agonies of finding a lump, having it biopsied, waiting on pathology, and then finding out it’s not cancer, but they’ll want to continue to keep an eye on her….she decided to have a prophylactic mastectomy. I stopped reading after that bit. She and Oprah don’t have to convince me of that being a wise choice.
But it’s funny because the first time I can recall hearing about a prophylactic mastectomy was not that long ago, really, and I had about the exact opposite reaction to the concept of a prophylactic mastectomy. I was living in Washington DC, and Newsweek had that cover story about three (or was it two?) sisters who had a strong family history of breast cancer and they followed their decision-making process about what they would do. I remember because I, at the time, couldn’t fathom being prepared to volunteer to have one or both of my breasts removed–this even given my own strong family history of breast cancer. Of course, I was in my early twenties, single, not a mother though wanted (probably) to be one someday, and the worst pain I’d suffered in my life so far–Jose Cuervo hangovers aside–was when I wore my extended wear contact lenses several months too long and developed corneal ulcers. Corneal ulcers really aren’t any fun, but they are still only in Double A ball of pain and suffering. Cancer and Chemo being the Big Show, of course.
Anyhow, so the ironic (Alanis ironic) part is that this issue was one that I knew, in the back of my mind, I might have to face someday. After all, my mother was diagnosed with breast cancer while I was in my early twenties, and her doctors turned to me and my younger sister, sitting in the office as he spoke to my mother, and pointed at us and said, “and YOU TWO, you are going to have to keep a very close watch on this for yourselves.” But even Dr. Doom didn’t get me thinking too hard about it, beyond a 30-second “oh my Gawwwwd I couldn’t decide!” immediately followed by a dismissive “well-let’s-just-hope-I-won’t-have-to-decide,” and resuming wacky-giddy single girl in the city life as was usual.
Haha on me! Oh, Universe, you are a scamp.
I’d always told OB/GYNs about my family history (my mother, her mother, and her mother all had breast cancer; my mother is the first to survive it) and they’d make a note of it, but there didn’t seem to be any real urgency to anything. When I turned 30, my new OB/GYN suggested that we take a baseline mammogram, saying that it would be good to have for the record, especially considering that my new husband and I were hoping to start a family relatively soon. Shortly after that humiliating experience, the OB/GYN called to say he needed better images, that they weren’t quite sure what they were seeing. Well, three mammograms later, he recommended I just see a surgeon for a biopsy. I’m still not sure how it all went down, but I went in thinking I was having a biopsy and I came out having had a lumpectomy. And the lump was benign and we all said PHEW and went back to talking about starting a family.
A year and a half later, we had newborn twin sons and I was in the shower one day and…found something weird. It didn’t feel right. I went to the (same) OB/GYN who said it was almost surely nothing to worry about, just some hormonal post-pregnancy thing going on that should pass when I started a new cycle. We waited a few weeks to confirm that theory, and in the meantime, I actually didn’t like touching it, tried only touching it as briefly as possible. I’d check only to see “is it still there? yes? okay stop touching it now!” The ultrasound that was supposed to confirm that it was just a hormonal post-partum thing didn’t confirm that and before we knew it, my husband and I (and our wiggly 8-month-old sons) were sitting in the surgeon’s office and he was outlining my options: another lumpectomy and radiation and chemo, or bilateral mastectomy and chemo.
Suddenly, I was in that position I hoped, back while reading that Newsweek article in the mid-’90s, that I’d never be in. And the funny thing was, that awful terrible decision I couldn’t imagine having to make, or even wrapping my brain around the concept in order to address it before considering it as an option? I KNEW WHAT TO DO.
It was crystal-clear obvious to me that I would be having a bilateral mastectomy despite having cancer in only one breast. I said something of that sort out loud, not necessarily to anyone in particular, and my husband nodded and said, “yes, I don’t want you to do all the surgery and chemotherapy and radiation and then have it come back in the other breast, and you’d have to start all over again.” I hadn’t thought of that, but that seemed like a good reason, too. I just felt like, for me, there was no point in keeping the breasts, whether or not both were diseased, if it increased the odds of my long-term survival.
So that is what we did. And while my poor sacrificed right breast was cancer-free (my mother’s sacrificed breast actually had pre-cancerous growth, so we all felt quite vindicated that she’d “made [hers] a double” as she said), we still felt it worth cheering when the path report came in with the oh-so-glad tidings that the cancer was not in my lymph nodes. I’ve never looked back, never regretted for a second, and kind of feel sorry for that Me-in-my-20s who found the mere question of prophylactic mastectomy to be hugely upsetting and difficult. No, difficult is not having the option, and therefore maybe not having the option to survive.
