High-Risk Gestapo
I've been spending the weekend reading up on the issue of genetic risk for breast cancer. This is about the BRCA1 and BRCA2 gene mutations that have been linked to a significant increase in breast cancer risk. For women who test positive for one of these gene mutations, their risk of contracting breast cancer in their lifetime can be as high as 85%. After getting breast cancer, the risk of later getting cancer in the other breast can be as high as 50%. In addition, BRCA1 and BRCA2 gene mutations are also linked to a heightened risk for ovarian cancer, as well as some other cancers.
It's all very serious stuff. It's serious enough that a number of doctors recommend that women who are BRCA1 or BRCA2 positive get prophylactic bilateral mastectomies (surgical removal of both breasts) to reduce their chances of getting breast cancer by about 95%. (It doesn't completely remove the risk because breast cancer can still develop in the chest wall.) Some doctors also recommend getting an oophorectomy (having the ovaries removed), too. Even when their doctor's don't make this suggestion, some women insist on these surgeries anyway.
I think I can understand why women might make these choices. First off, a lot of people are so afraid of getting cancer that they will do anything to prevent it. Finding out that they are at risk injects more anxiety into their lives, and that anxiety become very disruptive. Also, women who have these gene mutations usually come from families where breast cancer is common. That means they may well have watched loved ones suffer and die from this disease. Who can blame them for not wanting to go through that?
I support women who find preventative surgery to be the right choice for them. What I don't support, though, is pressuring other women to make the same choice. Bilateral mastectomy is not the only way to approach the issue of heightened risk. Some women choose to undergo aggressive surveillance instead, which may mean more frequent breast exams and mammograms or other screening tools. It's not so easy with the ovaries because it is difficult to detect ovarian cancer at early stages. But with breasts, it's different.
Yet, what I read online is women advising others with remarks like, "Your choice is a mastectomy now or a mastectomy later, with a side of chemo and radiation." Women refer breasts—not just their own—as ticking time bombs and question why anyone would have second thoughts about having them removed. They say they've already found their husbands and nursed their children, why not get rid of their breasts? After all, who needs them?
Well, crazy me, I want my breasts. I may not need them—I'm not raising children or trying to attract the attention of the men folk—but they are part of my body and I'm rather fond of keeping it intact. As far as I'm concerned, my breasts exist for my own pleasure. What on earth is wrong with having that influence my choice? Does it make me a bad feminist to be attached to my feminine body parts? Does this mean that if I tested positive and later had a recurrence, I would be held to blame?
Although, honestly, I’m not easily influenced by what others think I should do with my body. What makes my heart hurt, though, is when I see vulnerable women turn to others for guidance after getting a positive test result and watch them being told that there is only one correct choice for them to make. Deep down inside, we must know that there is never one right decision. Each woman must find what fits for her. If we can't help each other sort through our experiences to find our own truths, then do we really know what being supportive looks like?
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