Memoir: I had my breasts and ovaries removed in my thirties

Memoir: I had my breasts and ovaries removed in my thirties

My mother and grandmother both died of ovarian cancer. I wanted to avoid the same fate

(Illustration: Anastasiya Milova)

In 2006, my mother, Maria, was diagnosed with ovarian cancer. I was shattered. She had watched her mother die of the disease and now would have to suffer through it herself. It never occurred to me to worry about my own health—I was too busy driving my mother to doctors’ appointments and taking care of my kids, Gabriel and Lucas. My mom went into remission, but the cancer returned four years later.

Soon after the relapse, her oncologists suggested that she test for a BRCA mutation, a hereditary anomaly that makes people susceptible to breast and ovarian cancer. She had a one in 800 chance of being a carrier, but if she was, there was a 50 per cent chance that she’d passed the mutation on to my sisters and me.

We were shocked to discover that she was indeed a carrier. Both of my sisters tested negative, but I wasn’t so lucky. I was at home with my mom and my husband, Antonio, when the hospital called to tell me I’d inherited the mutation. I fell on the floor sobbing. I spent the whole night clutching Antonio and cursing my bad genes.

A few days later, I sat down with a genetic counsellor to talk through my options. She explained that I had a 40 to 70 per cent chance of developing breast cancer, and a 20 to 40 percent chance of getting ovarian cancer. She said I could have regular MRIs and mammograms to detect early signs of breast cancer, but they don’t always catch the disease early enough to treat it. She also told me there’s no reliable screening process for ovarian cancer. I could eliminate the risk almost entirely by having surgery to remove my breasts, ovaries and fallopian tubes.

I made up my mind before I was even out of her office. I was determined to avoid the same fate as my mom—even if it meant losing my breasts and reproductive organs at the age of 32. I talked it over with my family, and they agreed that I should do everything I could to safeguard my health. My relatives in Brazil were horrified. They said I was mutilating myself. “Why are you trying to play God?” they asked. But I never wavered. I couldn’t stand the idea of spending the rest of my life dreading the next doctor’s appointment, the next set of test results. I wanted to be part of my kids’ lives and to grow old with my husband.

In 2012, I had a bilateral mastectomy and breast reconstruction surgery. I opted for something called a deep inferior epigastric artery perforator flap, or DIEP, a procedure where doctors transfer fat and blood vessels from the abdomen to the breasts. The results are more natural-looking than synthetic implants, but I had so little belly fat that the surgeons didn’t have much to work with. I went into the surgery with C-cup breasts; I came out a smallish A cup (I eventually got silicone implants to correct the imbalance). My recovery was excruciating—for weeks, it hurt to breathe, sleep or put weight on my arms. I could barely touch my kids without wincing. Antonio was my lifeline. He assured me over and over again that he didn’t care what my body looked like. He loved me no matter what.

As I regained my strength, my mother’s health faltered. She’d lived longer than anyone expected, but the cancer had become resistant to the drugs. In the spring of 2014, she woke up with a raging fever, and we rushed her to the emergency room. Her blood pressure was dangerously low, so they couldn’t operate or even give her morphine without risking her life. She was screaming in agony. Finally, the ER doctor told me that the most humane thing we could do was ease her suffering. “Give me the pain meds,” my mom said. “I can’t take this anymore.” Within a few hours, she was gone.

After my mother died, I couldn’t do anything without breaking down in tears. I missed her desperately, but I was also crippled with anxiety about developing cancer. I’d been waiting to have my ovaries removed because I knew the operation would change my life—surgical menopause sends the body into instant estrogen withdrawal. The side effects are brutal. At that point, I didn’t care. I wanted my ovaries out.

The operation, called an oophorectomy, was done laparoscopically, and I was back on my feet in two days. Compared to the mastectomy, it was a breeze, but it changed me. Almost immediately, I experienced extreme dizziness, hot flashes and night sweats. My sex drive vanished, and, because of vaginal dryness, any attempts at intercourse were excruciating. Antonio was patient, and we found ways to adapt. It’s funny to think that two organs the size of walnuts could have such a profound effect on my identity, but they did. I’ll never be the same person I was before the surgery.

Still, I don’t regret my choices. I don’t mind flaunting my battle scars—I even wore a string bikini on a recent trip to Cancun. For everything I’ve lost, I’ve gained much more. Instead of living with the dread that I’ll die the way my mother did, and her mother before her, I’m looking forward to a future with my family. There’s not much I wouldn’t trade for that.

Andrea Magalhaes is a stay-at-home mom in Toronto.