Sometimes when unexpected news comes, it is shock that follows.

I experienced the feeling of shock at the age of seven, sitting on a couch in the formal living room in my childhood home when my mom told me she was sick.

I experienced the feeling of shock when I lost my mother to breast cancer at age fourteen.

I experienced shock when I sat in a genetic counselor’s office a few months ago and heard the words bilateral prophylactic mastectomy.

Bilateral Pro—phy—WHAT? 

Currently I am thirty-five, a pastor’s wife, and a mom to four kids under the age of ten. I am healthy. I just had my yearly physical and I had a clear reading on my latest mammogram.

When I was given the medical recommendation to have a preventative double mastectomy, it felt a whole lot like being thrown into a cold pool for a polar plunge. In many ways I felt like my head was below water and my extremities were paralyzed, unable to tred (breaststroke? not sure if that’s funny) in the waters where I had just been thrown.

Bilateral Pro—phy—WHY?

God has been preparing me for such a time as this. He has been writing a redemptive story for me in all of this, even from the time of my first feeling of shock at the age of seven.

Once I began to recognize the redemptive story God was writing for me, I was able to begin to tred water and think about the larger picture of bilateral pro—phy—why.

Why have all my breast tissue removed? Well, the PALB2 gene mutation increases my risk to 60%. One of my doctors said, “Rach, this is not a matter of if you get cancer, this is a matter of when.”

I have learned my mother’s cancer was unresponsive to treatment. And I have learned that the PALB2 gene is twice as likely to develop into the kind of breast cancer that does not respond to treatment. So this means this is not a matter of if I get cancer, this is a matter of when I will get deadly breast cancer.

A bilateral prophylactic double mastectomy reduces my risk of breast cancer from 60% to almost 0%. For me this means I am freed from the fear and anxiety I experience with each preventative scan.

Why am I choosing to have my breast tissue removed? I want to be healthy for my family.

Bilateral Pro—phy—HOW?

As far as I understand this, the bilateral prophylactic mastectomy will consist of two parts: the breast tissue removal done by a breast surgeon and the reconstruction done by the plastic surgeon. Step one: all my breast tissue will be removed and checked for any signs of breast cancer. Step two: in the same surgery a plastic surgeon will then begin reconstruction.

Reconstruction can be done in two ways: DIEP Flap where natural tissue is taken from another part of your body and moved to your breasts or implants. The DIEP Flap procedure is one surgery and a longer one time recovery. The implant reconstruction process is a shorter two part surgery and a shorter recovery.

After much consideration, at this time I believe the best option for me is to go the implant route. I have had four c-sections and I am not sure I can handle recovering from an abdominal incision at the same time as recovering from mastectomy incisions.

Bilateral Pro—phy—WHEN?

My surgery is scheduled for November 5th. I would appreciate your prayers as I adjust to this new normal over the next few months.

A bilateral prophylactic mastectomy may be a hard thing, but it is the right thing for me. I believe God renews us in the hard things . . . I believe He is good in the hard things . . . I believe He will be my help and my strength in this bilateral pro—phy—WHAT hard thing.