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"I Had a Double Mastectomy"

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"I Had a Double Mastectomy"
Shocking odds
Up to one in 800 women carries a BRCA mutation (unlike Basile, a Sicilian Italian, most are of Eastern European Jewish descent), and they face strikingly worse breast cancer odds than the general population. BRCA-positive women have an up to 87 percent lifetime risk of developing the disease, often before age 50—compared with just over 12 percent among women without the genetic marker, who are more likely to be diagnosed after age 60. Their risk for ovarian cancer jumps significantly too, from less than 1 percent to up to 50 percent.

A woman who learns she must live with this genetic guillotine poised above her has several options: heightened surveillance, involving frequent screenings to catch the disease early if possible; preventive chemotherapy with drugs like tamoxifen, which reduces risk by about 50 percent in women over 35; and removal of the ovaries and fallopian tubes, which can slash the chance of breast cancer by up to 72 percent. Basile, who is currently single, decided she wasn’t ready to lose her ovaries yet. “I’d like to have a child if the right guy comes along,” she says.

But she did make another tough—some might say extreme—treatment choice: to have both breasts surgically removed. Known as a prophylactic mastectomy, the procedure has been shown to cut the risk of breast cancer by 90 percent in those with BRCA mutations. In Basile’s case it would eradicate her DCIS and almost surely any recurrence of the disease. (The procedure can’t remove every single cell, so there’s always a chance that cancer will develop.) “I didn’t want to live my life with this knot in my stomach,” she says, “wondering every time I had a mammogram, ‘Is this going to be the one that shows cancer?’ ”

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