A Difficult Choice
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By René Syler

A Difficult Choice

Why I decided to have a prophylactic mastectomy

By René Syler


The end of a very long road is just hours away. It’s hard to believe I won’t be gripped by absolute terror as February, the date of my annual mammogram, draws near. No more wearing a flimsy gown, shifting uncomfortably on a chair, after just having had my breasts squeezed into the size and shape of a silver dollar pancake, only to have the tech tell me, “We need some more pictures.” Then the needles, the cutting, the waiting and wondering what battling breast cancer at my age would be like.

Those were the words I wrote to family and friends in January 2007, in an effort to describe my feelings on the night before my prophylactic mastectomy. I wanted those closest to me to know how much I appreciated the times they lifted me up and carried me on their shoulders.

Many people wondered how I could get my arms around such a big decision. How could a 43-year-old woman who did not have cancer choose to remove the very symbol of her femininity? But after four breast biopsies in four years, it appeared obvious to me—even without an MD after my name—that my breasts were not healthy.

Breast issues are nothing new to me or to my family. My father was diagnosed with breast cancer and underwent a radical, modified mastectomy while I was still a kid. Male breast cancer, while rare, is not unheard of. My mother, healthy her entire life, was one of the nearly 200,000 American women diagnosed with breast cancer each year. Her cancer, found on a mammogram, was very small, and she opted for a lumpectomy and radiation therapy. To this day, she has no sign of the disease.

Because of this bad genetic draw, I was closely screened for many years. This meant yearly mammograms, biannual visits to the breast surgeon, and seemingly endless MRIs and sonograms. On my mammograms, doctors saw microcalcifications, which showed up as tiny white specks and needed to be checked for signs of cancer. I constantly wondered if this was the year I would fight for my life.

Some years, the biopsy was done in a noninvasive way with a needle; other times, it required surgery. The end result was always the same: I did not have cancer, but I was sore—my body and psyche tattered.



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