The Devil You Know: Why I Chose to Remove Both Breasts

I had a double mastectomy with reconstructive surgery in December of 2009. I’m not a survivor, I did not have cancer. I am genetically inclined to get it, so I guess if anything, I am a pre-survivor — this was a proactive surgery. I never looked at my decision as brave. I just played the shitty card in the hand that I was dealt.

A few years before my surgery, my mom was diagnosed with stage-3 breast cancer. Her mother passed away at age 44 of ovarian cancer. It was pretty obvious I was a vulnerable branch on the cancer family tree. The first decision I had to make was whether I should have the genetic testing done. For me, it was a no brainer; I believe the devil that you know is better than the devil that you don’t.

No longer did I want to catch and beat cancer — I wanted to deny it the chance to play at all.

I tested positive for the BRCA1 gene. In a nutshell, this means I have (well, had), an 87% chance of getting breast or ovarian cancer in my lifetime. For perspective, the average population is about 10%.

My journey to surgery was swift. For a little while, I followed a “high-watch” plan. It was created and followed meticulously so I would catch the cancer early. Treat it early. And beat it. It meant that every six months I went in for testing, MRIs, mammograms, blood tests, physicals. Something was always suspicious, so it was always another appointment, another biopsy, another check up. I never thought about it as “if” I would get cancer — from the start I looked at is as “when.” It didn’t take long before I tired of this plan — and mindset.

For me, I had two clear options.

  1. Have a proactive double mastectomy with reconstructive surgery and eliminate my odds (down to 1%) of getting breast cancer.
  2. Get cancer. Have a proactive double mastectomy with reconstructive surgery. Then, most likely, go through chemotherapy, radiation and, oh yeah, possibly die.

This was my second no brainer. No longer did I want to catch and beat cancer — I wanted to deny it the chance to play at all.

And so the team assembled and a new plan was formed. I met with doctors, geneticists, oncologists, surgeons and surgical oncologists, the plastic surgeons my oncologist wanted me to interview. It seemed there were all sorts of medical professionals who wanted in on my case. I was a crystal clear living example of cancer genetics at its finest.

The author with her one-year-old daughter, Sophie Mae. (Photo courtesy Tricia Gately)

My surgery was difficult, but for me, necessary. After my “child bearing years,” as the doctors put it, I would have an oophorectomy, which would pretty much make the BRCA1 gene null and void in my body.

A few years later, I had a daughter of my own, which only makes me that much more thankful that I did this. She’ll never have to watch her mother fight breast cancer, and that alone would make me do it all over again. Unfortunately, my daughter does have a chance of facing the same decision, as there’s a 50/50 shot I passed this gene on to her. But she’ll be armed with the knowledge, and that is my gift to her. If there is one path on my windy road of life she’d choose to follow, I hope this one is it.

You can prepare and plan for a lot in life, but it’s the things that you can’t, the things that you never saw coming, that knock you sideways. When that happens, well, you just have to buck up, change course and make some decisions. Sometimes decisions are brave, sometimes they’re smart and sometimes they’re just about doing what you have to in order to survive.

My mom beat cancer; she’s six and a half years out. What she went though, the battle she fought and won, that’s brave.

My decision was based on fear. I was scared to get cancer, so I just figured out how not to get it and took the necessary steps to make that happen.

And lo and behold, I seem to have outsmarted the little fucker.

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3 Responses

  1. Editor’s Note: Are You Wearing One? | Tue Night

    […] And in a powerful story of will and survival, Tricia Gately explains why she decided to remove both breasts. […]

  2. Phil McCracken

    You also removed Burns testicles.

  3. Margit’s Note: The C Word | Tue Night

    […] Tricia Mackey elects to remove […]


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