The Inside of an Orange

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“It must have been pretty traumatic for you, seeing your mom die when you were so young.”

Staring out the window from my gynecologist’s office, I turn to look back at him, and with a slight grimace peeling over the left side of my face, I reply, “Yeah, yeah it was.”

This week I already had a whole post planned out to share with you guys, but over the last two days I decided that I need to stop and take a step back to introduce a new subject on this blog. Now whether or not I’ve purposely or mearly haphazardly avoided talking about it, well to be totally honest, I’m really not one hundred percent sure. Regardless, tonight I want to talk about how I’m coping with the possibility that I one day may be diagnosed with breast cancer.

My mother was diagnosed with breast cancer when she was pre-menopausal, which is roughly before the age of 45. My mom was 39 when she first found the lump in her breast. Given how young she was when she was diagnosed, it’s possible that she was genetically disposed to contracting breast cancer.

Since my mom was diagnosed, genetists have discovered that some people carry mutations in what what they call the BRCA1 and BRCA2 genes. In short, because let’s be real I’m not an expert in genetics nor are you all most likely (unless you are in which case we really should chat!) these genes produce proteins that help suppress cancerous tumors from forming. The BRCA1 and BRCA2 genes help repair damaged DNA, but when they’re not functioning properly, cells are more prone to becoming cancerous (click here for more).

I wanted to be tested for this genetic mutation back when I was in high school. However, research on these genetic mutations was still very much ongoing, and so long story short, my insurance company didn’t think that based on my family history I qualified for the genetic testing. And I don’t know about you, but I don’t have a few thousand dollars lying around for a cautionary medical test. Needless to say, I was never tested.

Fast forward back to 2017, and now both my primary care physician and my gynecologist think I should qualify for the gene test. In a few weeks I have a consultation appointment scheduled with the University of Miami Department of Human Genetics at the Miller School of Medicine. If they for whatever reason try to tell me I don’t qualify for the gene test, my gynecologist insists he’ll be able to get me tested.

Now here’s the deal, even if I don’t carry any genetic mutation, that doesn’t mean I’m out of the woods. My gynecologist explained to me that only approximately 20% of all breast cancer diagnoses occur as a result of this genetic mutation. The other 80% are considered to be sporadically occurring. But that just means I’m in the same pool of odds as all women in the US, so I can’t really be too surprised by that. The only real difference would be that I start annual mammograms when I’m 30 due to my mother’s early age diagnosis, but whatever that’s not a huge deal.

However, if I do carry the genetic mutation, my gynecologist strongly recommends I begin biannual mammograms and MRIs when I turn 25, which holy shit is just right around the corner, later this year in fact. And should I test positive for either of these mutations, my overall statistical likelihood of breast cancer diagnosis increases anywhere between 30 – 70%. Yikes.

As I’m staring at my gynecologist somewhat dumbfounded, he kind of perks up in his chair a little bit, coughs some of the stale air out of his throat, and says, “Don’t worry, the field of medicine surrounding breast cancer has changed a lot since your mom passed away. There are options you can consider to reduce your risk of contracting the disease, should you test positive for a BRCA mutation. There’s a fairly new and less invasive procedure, I’m not sure if you’ve ever heard of it, called the nipple-sparing mastectomy. Do you know what that is?”

I shake my head no.

He continues, “OK, imagine this. Imagine an orange. Cut a small incision into the orange, and turn it inside out. What you see is all the pulp and guts of the orange. Now, picture taking out all that pulp and everything inside, and then turning the orange back around…”

“So the inside is hollow” I conclude.

“Well, you’d put some implants in there, and so now on the outside it looks like you have a normal orange, even though you’ve taken out everything on the inside.”

Supposedly this procedure is an increasingly common and preventative measure women take to significantly reduce their chances of breast cancer diagnosis. It’s relatively painless, it causes virtually no scaring, and when I did some research on it, apparently most women retain nerve sensitivity in their nipples, so hey it can’t be all that bad, right?

But as I was driving home from the OBGYN office, I couldn’t help but feel slightly powerless over my own body. I may still be able to keep my breasts, but my breasts on the inside would no longer really be mine. Yes, every feminist and every motivational speaker in the whole world would tell me that my body is still my body no matter what, but it doesn’t change the void that I imagine I’d feel from basically losing my breasts. My breasts, my femininity, could potenially be gone, just like that. But at what cost, me risking my life? What choice do I have?

“Would you love me even if I had fake tits?” I giggle as I’m talking to my fiancé later that night as we’re getting into bed. He sighs because he hates when I engage him in self-deprecating humor, particularly late in the evening. “Honey, yes I’m going to love you, I obviously want you to do what’s best for your health.” He’s logical when I’m incapable of being logical, I swear.

Yet, as I was going to bed that night, I was staring down at my boobs, and all I could do was look at them and say, “Why do you guys have to make shit so complicated?”

And that’s what I’m dealing with right now, my own mortality crisis. Fundamentally, aside from any trauma I might experience from the results of genetic testing and any surgery that could follow thereafter, I would not only suffer from a lack of femininity, but I would suffer from the fear of losing my life. The last things I’m thinking about are hope and pink ribbons. So that’s what I’m talking to you all about tonight, not just saving my tits, but potentially saving my god damn life. And I’m scared as hell.

5 comments

  1. This is a great blog entry. I actually had a discussion with a young woman lately about this exact topic. I wrote a blog about taking the BRCA test (I am a breast cancer survivor and tested BRCA1 positive), but just some things to take into consideration when contemplating if you want to take the BRCA test or not. If you’d like to have a read, here’s the link: https://battlingbreastcancerandbeyond.com/2016/11/29/should-you-take-the-brca-test/

    Liked by 1 person

    • I will definitely give this a read! It’s nice to be armed with the opposite perspective before making this decision. Regardless of my decision I hope you keep reading my blog and sending good vibes my way ❤️

      Like

  2. Appreciated your vulnerability. I am BRCA1 positive. I just began blogging, you’re welcome to visit. Hoping you won’t need my insights, but you’re welcomed to then. Brcabrat.wordpress.com

    Like

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