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An Open Letter to Angelina: Welcome to the Sisterhood

Gage Skidmore for Wikipedia (CC Licensed)

Dear Angelina,

Welcome to the sisterhood. The exclusive club of one in eight women who will get breast cancer in their lifetime, according to the National Cancer Institute. Only now you probably won’t, and I can tell you a little of what you’re missing out on.

I’ve been a card carrying member since 2008, complete with a Memorial Sloan Kettering Cancer Center ID tucked in my wallet. Just last week I graduated from six-month visits with my breast surgeon to the MSKCC “survivorship” program, my annual MRIs downgraded to ultrasounds. Tomorrow I see my oncologist, who with any luck will reduce her demands on my time as well. It’s a weird feeling. Liberating to see the non-stop medical tests and appointments winding down, but it’s also like being forced out of a cozy nest of support: Is this really it? Am I ready? What if we miss something?

I too have children, three of them to be exact, including a teenage daughter who will have to deal with this legacy in the not too distant future. I had my genetic testing after the fact. Unlike you I did not carry the BRCA gene or have any close family history of breast cancer. Just the bad luck to become a statistic in my 40s, a few decades ahead of the norm. I don’t carry much of a risk of recurrence, but once you have cancer, every little bump or ache is more than a bump or ache. Knowing what that’s like to live with now, I would have opted for a double mastectomy like you instead of the “single” that was encouraged at the time.

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My daughter will someday face the same decision you just made, as will your Shiloh and Vivienne. According to my geneticist, my early-age diagnosis, coupled with the fact that my daughter has a paternal aunt who also had breast cancer at an even younger age than I did (in her mid-30s), and that we have a history of related prostate cancer on both sides of our families, makes her much more vulnerable than I was. I don’t know her exact odds. I was honestly just too afraid to ask at the time. But I do know that for her, the testing will begin in her mid 20s, at an age when she should be building a career, falling in love, and living a fun, fearless life instead of worrying about serious illness.

But here’s the good stuff we’ve given our daughters (and sons): Strong role models. You did the right thing, Angelina, confronting your destiny and stomping it out. I would have done the very same if I had the choice. And I will encourage my daughter to do so if her odds turn out to be equally daunting. You are also correct that we are not any less feminine with reconstructed breasts. Feminine today means strong and smart, not wimpy or passive. Women like you and I don’t wait for life to happen to us. It was a drastic step to be sure, but a beautiful gift you’ve given your family.

Of course it will be both lauded and debated. Right now the Twitterverse is exploding with quips on the cost, the controversy over whether BRCA testing is necessary, the concerns over potentially unnecessary surgery. This judging is way out of line. Cancer is damn scary. Only when confronted with our own individual vulnerability can we truly say what is the best decision for us as both women and mothers. Cancer treatment certainly takes its toll as well. In addition to the surgery you had, there is radiation and chemo and tamoxifen and early menopause. The change in our breasts is in fact but a small part of the havoc wreaked on the rest of our bodies. Yes, you went through a lot the past few months, but trust me, it could have been worse.

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My kids occasionally still ask about my cancer, usually when they hear about a friend whose parent has been diagnosed, or heartbreakingly, a child in our community who has it in some form or another. They’re tweens and teens now and can understand some of the medical explanation I provide in a valiant attempt to reassure them that my situation is different from whichever scary story they’re hearing. But the strongest proof of our ability to conquer cancer is me standing at the kitchen counter, me going out the door to work at the same time they go to school, me next to them on the sofa rooting for contestants on The Voice. Just being a normal mom, living a normal life. For you and me and our families, that’s powerful stuff.

I’m sorry this had to happen to you too, Angelina, but I am also grateful that you will use your voice and your resources to bring breast cancer prevention and treatment to many less fortunate. As they say, God works in mysterious ways, and this seems like a smart move on his or her part. Bravo, mama, bravo.