Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own. Matthew 6:34
The next steps for me were having an MRI and waiting for the insurance company to decide whether they would pay for my genetic testing. I had the MRI on March 14, 2012. The insurance company sent two letters dated February 22, 2012. The first letter stated that BRCA testing “is not useful as a routine screening test”, indicating that they would not pay for the testing. The second letter said that they would pay for the test based on a review of my family history. Just like that, it was done. I was going to learn the truth, good or bad. Ignorance was bliss, and I wondered if I would want it back once it was lost.
I went to Dr. Skrine for my test results on March 26. She had already indicated that the lump was most likely benign, and I could tell it had receded. For me, that was the big issue – I had spent more weeks than I wanted to count believing that I had breast cancer, and that fear had abated. As I didn’t expect any shocking news from the MRI, I told Mark not to take off work. I assumed the genetic test would be positive, and felt prepared for that, since I had always figured I had the same predisposition my mother, grandmother, and great-grandmother had. I believed she was going to tell me to come in every year for monitoring, maybe increase the frequency of my mammograms and self-exams, and send me on my way.
I was right about the positive result, but I was absolutely wrong about being prepared for what was coming and about being able to handle this appointment alone.
I tested positive for a BRCA1 deleterious mutation, technically a “2594delC” mutation. The BRCA fact sheet at Cancer.gov states that a BRCA1 or BRCA2 positive condition makes a woman five times more likely to have breast cancer. Statistically, that means for me (not having had breast cancer before):
Likelihood of breast cancer by age 50 – 50% (General population’s risk – 2%)
Likelihood of breast cancer by age 70 – 87% (General population’s risk – 7%)
Likelihood of ovarian cancer by age 70 – 44% (General population’s risk – less than 2%)
Likelihood of pancreatic cancer by age 80 – 4% (General population’s risk – less than 1%)
The number that rang in my head was the 87% likelihood of breast cancer by age 70. Considering my mom’s early-onset breast cancer (age 35), the age meant less than the percentage. EIGHTY SEVEN. In other words, “you’re doomed, have a nice day.”
I listened as Dr. Skrine recommended an immediate double mastectomy. The surgery itself wasn’t a huge surprise – like I said, I’d considered it. Mom did it, so I knew it was something that could be lived with. I wasn’t ready for the word immediate, or what followed. Dr. Skrine recommended a full hysterectomy as well. That was a bigger surprise, since the risk was 44% by age 70 – to me that sounded like a 50/50 shot.
Suddenly, I remembered something I hadn’t thought of in years. I was working at a bank when Mom was diagnosed with ovarian cancer and had her hysterectomy, and my supervisor had one around the same time. I remembered a conversation with her, during which I explained that Mom had also had a double mastectomy. Her response was, “Wow. She’s more of a woman than me. Well, I guess maybe not now.” It was a horrible thing to say. Those thoughtless words came back to me now, as I faced being technically “less of a woman” myself.
Within an hour, I had marching orders: make exploratory appointments with three plastic surgeons, and see an oncologist. NOW. Dr. Skrine was frank, but so understanding. She prescribed Tamoxifen for me, warning me that it can cause menopausal symptoms. Somehow this was just crushing – we weren’t planning on having more babies, but I did want to be myself.
Dr. Skrine walked me out and hugged me. I didn’t quite make it to the car before the tears started. I called Mark, and ruined his day.
I couldn’t help wondering what Mom would think. I am a worrier, and she used to say, “Don’t borrow trouble.” She was paraphrasing Matthew 6:34, “Therefore do not worry about tomorrow, for tomorrow will worry about itself. Each day has enough trouble of its own.” I couldn’t help but wonder if by doing this test I had borrowed tomorrow’s trouble.
Stories From the Furnace 