Until last spring I had to explain what it meant that I have a BRCA mutation. Then Angelina Jolie wrote her amazing op ed piece and suddenly everyone knew what it meant – or thought they did. Except they also thought that all of us so-called mutants or previvors have preventive mastectomies (PBM), if we are lucky enough to learn that we are BRCA positive before we already have cancer.
And I’m not having a mastectomy. Some women do, for reasons that make it the right choice for them. I support them in that difficult choice. But it’s not right for me. I’m choosing surveillance, getting a mammogram every December and a breast MRI every June. I did have my ovaries surgically removed – since there’s no good way to check for ovarian cancer, and with 3 young adult sons our family is complete. But I’m not having a PBM, despite the elevated risk of breast cancer that I face.
In the years since my positive BRCA test, I have had a lot of surprises. Angelina’s brave decision to share her story in that op ed piece was one. A second surprise came when I unexpectedly discovered, through the genetic counseling process regarding our particular mutation, that I have Ashkenazi Jewish heritage. So I’m not the total WASP I once thought I was. And then just a couple months later my husband told me we were relocating to Austin Texas (yes, Texas) after spending all our adult years raising a family in the San Francisco suburbs. But dwarfing all of those – yes, bigger even than moving to Texas – was the surprise of my mother’s positive BRCA test, the starting point for my family’s journey through the land of elevated risk.