Angelina Jolie was not the only one to choose a prophylactic mastectomy.
I did, too. – but for different reasons. (Thank you, Angelina, for making it public. You’ve given me the courage to write about it for the very first time. And now, I can’t imagine why I was silent for so long).
When I was diagnosed with breast cancer almost 25 years ago, the words “prophylactic mastectomy” were not commonly uttered. Breasts that were diseased were removed; otherwise healthy tissue was left intact.
Since then, a lot has transpired. Some (though not all) physicians advise women who have had cancer in one breast to have the opposite one removed, just to be “safe.” Many women choose to have prophylactic mastectomies on the opposite breast for psychological reasons: the anxiety that cancer will occur again (though not scientifically based in all cases) is so high to render them unable to deal with the heightened ongoing stress. And we all know what a huge health risk stress can be. The last thing a woman with cancer wants is any more health risks.
Other women opt to have their opposite breast removed so that their bodies feel more symmetrical, or “even.” If they opt for reconstructive surgery, the results will be more esthetically pleasing.
And of course, having the BRCA gene mutation, which makes the odds of developing breast cancer climb to dizzying heights, warrants a prophylactic mastectomy, along with other choices like watchful surveillance and/or hormonal therapy.
My decision to have my healthy breast removed came easily to me: I went for my first mammogram after having a mastectomy on my left breast and completing a 6-month course of chemotherapy. Just driving into the parking lot for my appointment filled me with overwhelming weakness and dread.
Words and feelings crowded my mind I entered the double doors of the medical building, as clear as it was happening all over again. (“We need to take more views.” “Cancer.” “Biopsy.” “Odds.” “Surgery.” “Malignancy.”)
When the technician placed my right breast into the machine and slowly compressed it, I felt faint and numb. When she left the room and came back in a few minutes later to take more views, bile rose in my throat. “Oh, no,” I thought “I can’t go through this again.” My children’s young faces invaded my sight. The poison words surfaced again.
I waited. I paced. I tore at my ragged cuticles with my teeth. Twenty minutes felt like a full day. It turned out that there was not cancer in my opposite breast, but by the time I found that out I had already decided.
It took a lot of searching to find a doctor who would understand. One doctor dismissively looked me square in the eye and said, “I DON’T remove healthy tissue.” I felt ashamed. Another told me there was no scientific basis for my request. I felt disappointed. Others wouldn’t even see me. I felt angry.
In case you’re wondering, I got tested for the BRCA gene mutation shortly after my diagnosis. I was young when I developed breast cancer (34) and I was searching for a reason. I am of Ashkenazi descent (the mutation occurs more commonly in certain populations, and this is one of them). It turns out I did not have the defect. But that would not change my decision.
A few months later, I found an empathic, experienced reconstructive surgeon who understood how I felt. He did not judge. He did not question. He got it. He would reconstruct my lost breast. He would prophylactically remove my other breast and reconstruct it too.
The healthy tissue was biopsied. There were no cancer cells present.
Peace of mind is priceless.