Sarafina Nance

I lost my breasts, but an early test saved my life


Cancer is a raw reality of life for my family, which meant that I, too, was put at great risk from an early age. For me, it was the risk of getting breast cancer. Fortunately, when it came to knowing my options for risk, detection and mitigation, I’m one of the lucky ones, as 1 in 3 women in the United States today don’t know their treatment options. I am sharing my story in hopes that we can close this education gap.


When I was 11, I lost my grandmother to pancreatic cancer after an already long battle with ovarian cancer. I also had countless family members with breast, throat and skin cancer. When my dad was diagnosed with metastatic prostate cancer, I was devastated, but hardly surprised.


The biggest surprise, though, was how aggressive these cancers were. My dad’s prostate cancer progressed to Stage IV in six short months, utterly shocking his doctors and our family. The tumor’s aggressiveness coupled with our family history was a red flag, and his oncologist suggested that both he and I get tested for the breast cancer susceptibility gene (BRCA) mutation. I was 23. I’ll never forget the call from my dad’s oncologist, “You’re BRCA2 positive.” This mutation gives me an 87% chance of developing breast cancer and a 30% chance of developing ovarian cancer throughout my life.


I was terrified.


In that moment, my dad’s oncologist became my own. He walked me through my risk, but also my options: annual screening MRIs starting at age 25, a preventive double mastectomy, a preventive oophorectomy (removal of my ovaries), preventive chemotherapy, IVF and preimplantation genetic testing, among many others. Knowing my mutation allowed doctors and geneticists to create a game plan unique to me and my risk. That knowledge was powerful!

Instead of feeling paralyzed by fear, I felt empowered, and grateful ...


After discussing with my genetic counselor and oncologist, I knew I would choose to have a preventive (or prophylactic) double mastectomy.


I got my first baseline MRI screening at 25, and within 3 hours my oncologist called me saying they found something. I was petrified. I remember calling my dad in tears, asking what would happen if we both had cancer at the same time. Thankfully, my biopsy came back benign, but after discussing with my oncologist, we both agreed that I was ready for my double mastectomy.


In learning about my diagnosis and searching for doctors and surgeons, my research experience as a Ph.D. student served me well. I combed through the literature, poring over articles and creating a glossary of relevant medical terms and studies for my case. I interviewed countless surgeons and offices. Many told me that I was too young, or that they couldn’t operate because I don’t yet have cancer.


Through this process, I learned to advocate for myself and to trust my gut. I knew I’d found the right surgeon when I walked into my first consultation with Dr. Anne Peled. Armed with seven pages of notes and citations, she put her notes down, invited me to talk, and said she had all the time in the world to listen and discuss. She was perfect. Not to mention, she had survived breast cancer herself and understood what it was like from my perspective.


Together, we devised a plan to mitigate my risk. I was set for a two-part surgical process. My first surgery was a breast reduction, to create the ideal pocket for implants and to maximize my likelihood of retaining my nipples and sensation in my breasts. My second surgery was a hidden scar mastectomy and reconstruction with implants. I chose this procedure because it was less invasive than other procedures and would leave no visible scarring.


Yes, I’m devastated that I lost my breasts. But I’m excited to be able to do something about my risk. My mastectomy will lower my risk of breast cancer to less than that of the general population, around 8%. I’ve used my diagnosis as a way to check my health and, with the help of diet and exercise, become the healthiest, strongest possible version of myself that I can be. In short, I’m training my body and my mind to tackle my cancer risk in every possible way.


My BRCA diagnosis filled me with fear, anger, sadness and resentment. At times, I still have those feelings. However, I also feel so much gratitude, relief and confidence in taking proactive steps to face and overcome my fears. Thankfully, my recovery is going well.

For those facing my ordeal, I hope that my story encourages you to take some time to educate yourself about the risks of getting breast cancer and available preventative treatment plans. Knowledge is power, and so ask questions — lots of questions.


It may just save your life.


Article Source: http://www.sfchronicle.com