For people facing breast cancer or living with a high risk of developing it, some of the biggest decisions of their lives can arrive at the exact moment they feel least prepared to make them.
Lumpectomy or mastectomy. One breast or both. Surveillance or preventive surgery. Reconstruction or going flat. Implants or your own tissue. Nipple sparing or not. And sometimes, there is very little choice at all.
In Episode 2 of BRCA & Beyond’s Breast Cancer Awareness Month series, Marisa talks about the emotional weight behind breast cancer and high-risk decision-making and what it feels like to make permanent decisions about your body while navigating fear, uncertainty, information overload, and everyone else’s opinions.
Marisa shares her own experience of choosing a preventive double mastectomy, including the abnormality found on her first mammogram, undergoing additional imaging and a biopsy, realizing that ongoing high-risk surveillance was not something she personally wanted to live with, and the fear and doubt that followed even after she made her decision.
She also opens up about something that played a major role in her decision-making: the unknown. What would her body look like after a mastectomy? Would she recognize herself? Would she regret removing healthy breasts? And how much uncertainty was she willing to live with if she chose surveillance instead?
Because making a decision does not necessarily make the fear disappear.
This episode also explores the outside opinions that can make an already difficult decision even harder. From being told to “just get the mastectomy” to hearing “but you don’t even have cancer,” the people around us often have strong opinions about choices they will never personally have to live with.
There is no single right decision for every person.
Instead of searching endlessly for the perfect answer, Marisa shares four questions that helped her navigate her own decision:
What matters most to me?
What am I most afraid of?
What kind of uncertainty can I live with?
What would I choose if nobody else had an opinion?
Whether you are newly diagnosed with breast cancer, considering lumpectomy or mastectomy, living with hereditary breast cancer risk, deciding between high-risk surveillance and preventive mastectomy, exploring breast reconstruction options, or simply trying to understand what someone you love is facing, this conversation is about making room for both the medical facts and the person who has to live with the decision.
Because sometimes the choice is not between right and wrong.
Sometimes it is hard versus hard.
- National Cancer Institute: Surgery to Reduce the Risk of Breast Cancer
Information about preventive mastectomy, who may consider it, its benefits and limitations, and alternatives to surgery.
- National Cancer Institute: Breast Cancer Surgery
Information about lumpectomy, mastectomy, breast reconstruction, and factors to discuss with your medical team.
- National Cancer Institute: Genetic Testing for Inherited Cancer Risk
Guidance on genetic testing, hereditary cancer risk, genetic counseling, and understanding your results.
- Breastcancer.org: Types of Breast Reconstruction
Information about reconstruction options, including implants and tissue-based procedures.
- Breastcancer.org: Going Flat After Mastectomy
Information for people considering aesthetic flat closure or choosing not to have breast reconstruction.
If you are facing decisions about breast cancer treatment, hereditary cancer risk, surveillance, or preventive surgery, talk with your own healthcare team about the benefits, risks, and alternatives that apply to your individual medical history. A breast surgeon, medical oncologist, genetic counselor, plastic or reconstructive surgeon, oncology social worker, or mental health professional may also be helpful depending on the decisions you are facing.
","author_name":"Marisa Stachelski, Cancer Survivor & BRCA2 Previvor"}