Brave Decisions

Since learning that I have a BRCA1 mutation, all three of my sisters have also been tested to learn their BRCA status. I don't know if it's good news or bad news that only one of my sisters came back positive for BRCA1, too. Sister Number Three, the youngest at 28, has inherited the same increased risk of developing breast cancer and ovarian cancer as I.

It's a miserable situation for anyone to be in. But my heart breaks in a more delicate way for her. Like tiny bits of fine crystal that sing the moment they shatter and scatter. She, who is in a happy relationship but unmarried, who wants very much to have children of her own, and has slogged through some challenging personal matters over the past several years, is now facing a potential -- but not forgone -- breast cancer diagnosis. And she's closing in on my age at diagnosis.

She's now in the position of having to make some of the toughest decisions of her life in order to maybe save her life. Stay aggressively vigilant? Undergo prophylactic mastectomy? Reconstruction? What kind? What about her ovaries? Do they stay or go? What will she look like after surgery? How will she feel about her new body if she undergoes surgery? How will this affect her relationship? Bilateral mastectomy means no breastfeeding should she have children. That's a joy she'll never know. A miss. Lots of missing things.

The good news is that the chick is rather resourceful. She quickly found Bright Pink, an organization that provides support to young women who are at high risk for breast and ovarian cancer. They have been a phenomenal resource for her as she navigates this new and difficult path.

And she has made a decision. She will undergo bilateral mastectomy with reconstruction. It took my breath away when she told me. The enormity and finality of the decision... and she just stepped up and claimed it. Courageous, is the only word I can think of to describe her.