This was the question that haunted me last October. At 21, I was just beginning my senior year at USC. My mind should have been occupied by my sorority’s formal and writing cover letters; instead it was bogged down by cancer and the looming realization of my own mortality.
A month earlier, my mom had been diagnosed with breast cancer for the second time in 12 years. The doctors at UCLA Medical Center suspected that there was more than just bad luck at work, so she was tested for genetic mutations related to breast cancer.
The day she received her test results, she drove straight from UCLA Medical Center to my office in Santa Monica. We went out to lunch, and she wasted no time in telling me that she’d tested positive for a BRCA 2 gene mutation.
For my mom, the BRCA mutation meant that her multiple cases of breast cancer were caused by ineffective tumor suppressors, and it determined that a bilateral mastectomy would be her course of surgical treatment. She would also need to have a prophylactic oophorectomy, since a BRCA mutation also increases a woman’s risk of ovarian cancer.
For me, the BRCA mutation meant that I had the opportunity to see into my future. For years I had been weary of the fact that I had a higher risk of getting breast cancer than other women; now I could know for sure.
The next day I went to UCLA for my own blood test. The genetic counselor talked to me about what a BRCA mutation really was and what the options were for a woman who tested positive: vigilant surveillance, or surgery.
What would I do if I knew I was going to get cancer? I wondered. Would I sit back and wait for it to strike, or would I take action? This was my chance to know.
Two weeks later, I received my test results: I had inherited my mom’s BRCA 2 mutation. My future read breast cancer, with a strong possibility of ovarian cancer.
Nothing felt important anymore. School was a joke; my social life was meaningless; job searching seemed pointless. It would all be for naught when I got breast cancer—because it wasn’t an "if"; it was a "when." Not all women with BRCA mutations get breast cancer, but most do. And the way it had played out for my mother made me positive that I would get breast cancer at some point in my life.
I let myself sulk for a few days, crying and feeling like a martyr of sorts. Then I got sick of the moping, and remembered the question I asked myself.
So I took action. I spoke with my genetic counselor, then a plastic surgeon, then a breast surgeon. I started looking at dates and talking to my family. And from all of these conversations I made the decision to go forward with a prophylactic double mastectomy.
My mastectomy was March 13, 2012 at UCLA Medical Center. I went into surgery early in the morning, a scared 21-year-old with what felt like ticking time bombs glued to my chest. I woke up five hours later in a recovery room, a loopy 21-year-old (anesthesia gets you!) with a giant grin. My breasts and fear of cancer were gone, replaced by tissue expanders and a sense of relief.
Tissue expanders are part of the breast reconstruction process. They are placed under the chest muscle to gradually stretch the muscle to prepare for a permanent breast implant. During my mastectomy surgery, my plastic surgeon put about 200 ccs of saline in each tissue expander. Over time, more saline has been added.
It’s been almost seven months since my mastectomy, and every day I am glad to have made that decision. The journey hasn’t been easy; I was hospitalized for a week in April and had to have my left tissue expander temporarily removed due to an infection. But now I’ve got 700 ccs of saline in each tissue expander, and my implant exchange surgery is scheduled for November.
At age 21 I looked breast cancer in the eye and said "no way." Some people call my decision brave; I call it necessary. And as more women learn about the BRCA gene mutations and their own increased risk of breast cancer, they start to consider the same decision. To help them decide if a mastectomy is the right choice, I’ve started a blog, Ticking Time Bombs. It’s an honest documentation of my journey, complete with the ups and downs, pictures, and some humor to boot.
I hope that my blog makes these other young women feel less alone and confused. I want them to know that it’s entirely possible to live a normal life following a mastectomy, and I don’t want them to be scared of the option. Because although it might seem ludicrous, it could be life-saving.
My journey with cancer will never entirely be over: every 10-15 years my breast implants will be replaced; I will have to face the possibility of passing my BRCA mutation onto my children; and around age 40, I will have an oophorectomy to eliminate my risk of ovarian cancer.
But at least I know what the future holds for me. My BRCA mutation is a curse, but in a way, it’s a blessing too: at age 21, I had a prophylactic mastectomy. I stopped breast cancer before it could stop me.