BREAST CANCER IS ALMOST A QUARTER OF all malignant tumors in women, and the predisposition to it is greatly increased in the presence of mutations in the BRCA1 and BRCA2 genes. An analysis for these mutations is recommended for those who have had family history of ovarian or breast cancer; when they are detected, the risk of the disease is very high, according to some data – up to 87%, that is, cancer will develop almost certainly. In this case, doctors can offer a choice between very close observation, when the examination is carried out every six months and is aimed at finally revealing the tumor at the initial stage, and preventive mastectomy, that is, preventive removal of the mammary glands.
We have already talked about the movement of previvors, or “pre-survivors” – these are women who have undergone preventive mastectomy, who talk about it, raising the awareness of others. Anna Nikolaeva told us how and why she made the decision to remove the mammary glands and how her life changed after the operation.
I am twenty five years old; at the end of February, I underwent a preventive mastectomy with one-stage reconstruction – this is the name of the operation to remove the mammary glands and replace them with implants.
When four years ago my mother was diagnosed with ovarian cancer, and before that almost all relatives on my mother’s side were sick or dying of cancer, I realized that in the future I would have to remove my mammary glands and ovaries. True, I assumed that it would not be soon. At that time, the doctors explained that once every six months, just in case, you need to donate blood for tumor markers, and I did this for three and a half years until I came for a consultation with a plastic surgeon.
Big breasts began to bother me at school – the older I got, the more difficult it was to live with it ; in the end I decided to decrease it . I did not choose a surgeon for long – I decided to turn to the same specialist, whose mother had done several cosmetic surgeries before her illness. I thought that I would have to persuade the doctor to reduce my breasts, and he would answer in the spirit of “here you will give birth, then come.” But the meeting went completely differently.
Immediately after the story about my mother – at that time almost six months had passed after her death – the doctor asked me when I had the last breast examination. I never did this, because, like many, I believed that until the age of thirty-five it was irrelevant. The doctor issued a whole list of things to do: ultrasound, radiography, examination by a mammologist and a blood test for mutations in the BRCA genes. He explained to me that, of course, it is possible to reduce the breast, but before making a decision, you need to get the results of all tests and, if there is a mutation, consider the option of mastectomy.
By that time, I already had positive results
for the mutation in BRCA – and I knew that
there was an
85–90% chance of developing breast cancer . So I have already decided everything about myself.
Such a result of the consultation, of course, surprised, but I decided not to make hasty conclusions and start the examination. It was not easy to sign up for all the procedures: the same chest x-ray is usually not done until thirty-five years old. My next mistake was to tell the mammologist about the real reason for the visit: having mentioned the planned plastic surgery, I, of course, received the very same comment about the age and absence of children. However, by that time I already had positive test results for the BRCA1 gene mutation – and I knew that breast cancer would develop with a probability of 85–90%. So I have already decided everything about myself.
On ultrasound, I was found to have a small formation, which was most likely benign, but nevertheless I obeyed the doctor and went for a consultation with a mammologist-oncologist at one of the most famous cancer centers in Moscow. The trip there was another mistake: I had to listen to a bunch of dissatisfied comments about my doctor and leave with the wording “this is hardly a malignant formation, but I would have watched you” and referral for another ultrasound in a month.
As a person familiar with the unpredictability of cancer firsthand, I decided not to tempt fate anymore: I decided on a mastectomy, came to the surgeon and showed him the results of all examinations. He supported me. Although it was not without obstacles: two more doctors were present at this consultation, and each had their own opinion about my situation. I listened to them, went home and thought for some time. Of course, removing the mammary glands at twenty-five is not an easy decision. But I am sure that a living mother will be more important to my children than breastfeeding. Fortunately, all my relatives and friends fully supported me.
The date of the operation was set two weeks in advance. At that moment, for the first time, I began to get really nervous, I began to search the Internet for women’s stories about this operation and did not find anything. It was frightening and embarrassing, but I had no choice.
The operation lasted about four hours and went well; I spent the next week in the hospital and mostly slept from a lot of painkillers. I was very lucky: my loved one was there all the time, who helped in everything. I remember a special pleasure when, four days after the operation, I was able to wash my hair. The entire staff of the clinic was very attentive to me, for which I am incredibly grateful to them – there were moments when something hurt, I cried, and the nurses calmed me down.
Then, while still in the hospital, I started posting videos on Instagram and wrote about the operation on Facebook. Before her, I thought for a long time whether it is worth making the story public – or it is better to let only the closest know about it. I made the decision a few minutes before the intervention, posting the first story. I thought that this way I could help women who find themselves in a similar situation. In return, I received tremendous support, which was especially important then.
Upon returning home, I faced a new problem. Despite the fact that I really wanted to return from the hospital, I did not think that I would be on my own, and there would be no paramedics around. On the very first day, I started to panic, I was afraid to move again. The slightest change in the state caused a lot of anxiety, and it was very embarrassing to constantly disturb the doctors. The first week at home I lay in bed – after the operation I did not have the strength, although, of course, I wanted to quickly get back to doing household chores, work, meeting friends and living a normal life.
I was never prone to panic, but in those days I was worried about the slightest trifle, constantly looked at my breasts in the mirror and was afraid that after the operation it would be ugly or uneven. Of course, I understood that this was stupid – after all, the intervention was not for the sake of appearance, but for the sake of a quiet life. But losing control of my body was still scary. I was covered with a terrible apathy. Friends came, dad returned from a business trip, everyone supported me, and slowly I came to my senses.