I had to be resilient when I found out that I tested positive for the PALB2 gene mutation and needed to decide on how I would proceed for my health, specifically for breast cancer…while my daughter was in hospice.
Resilience is often mistaken for bravery without fear. My lived experience has taught me the opposite. Resilience is not the absence of fear—it is the decision to move forward while afraid, while grieving, while unsure of the outcome. My decision to undergo a bilateral mastectomy was born not from certainty or confidence, but from factoring in aspects of motherhood, medicine, loss, and love.
I am the mother of three children, one of whom lives with a rare disease and is currently receiving hospice care. I am also a physician, yet none of my medical training could prepare me for navigating my own body, my own mortality, while simultaneously parenting a child who was facing their own mortality. Our lives have long revolved around uncertainty. For years, we pursued extensive genetic testing in hopes of identifying the cause of my daughter’s condition. Each test came back inconclusive, and each answer was delayed. The irony is not lost on me that while we struggled to find a gene to explain her illness, one quietly existed in my own body, unknown and unconsidered.
My family history is marked by cancer—breast, ovarian, and pancreatic. Years ago, I was tested for the BRCA gene, and when it came back negative, I felt safe. Relieved. Protected by the limits of what was known at the time. I allowed myself to believe that cancer was something that had touched my family, but not something that would touch me. At a recent annual gynecology appointment, however, I was offered updated genetic testing based on my family history. I felt grateful for the progress of medicine and agreed without hesitation.
When the results came back showing a PALB2 mutation, I had no idea what that meant. Like many patients, I found myself Googling acronyms and statistics late into the night. What I learned was sobering. A lifetime breast cancer risk as high as 52%. Elevated risks of ovarian and pancreatic cancer, both five times higher than the average person. The illusion of safety I had carried for years dissolved instantly. I was no longer an invincible supermom and physician- I was forced to pause and look at my own health and mortality.
The first decision was clear in theory but agonizing in practice: how to reduce my risk of breast cancer. Do I watch and wait, committing to intense surveillance and the constant fear of what might be found? Or do I pursue a bilateral mastectomy, an irreversible decision that carries its own physical and emotional costs? Both options felt overwhelming. Both felt impossible.
When I met with my oncology team, I spoke my fears out loud. If I delay surgery and develop cancer, will I be facing chemotherapy while my daughter is actively dying? If I wait until after she dies, will I be recovering from major surgery while my other children are drowning in grief? Was there a way to remove at least one looming threat from our already fragile lives? I did not want to add cancer to the long list of things my family had to survive.
Ultimately, I chose surgery. Not because I was fearless—but because I was afraid of everything that could happen if I didn’t act. I chose to take breast cancer off my worry list, even though the decision terrified me. Succumbing to major surgery humbled me in ways I did not anticipate. I am accustomed to caring for others; suddenly, I was dependent. The physical toll was profound. I could not climb the stairs. I could not bathe myself. I relied on my husband for care in ways that mirrored how he cares for our daughter every day.
There were moments of painful symmetry. We took turns using the chair lift when I could not manage the stairs. We shared the bath chair as my husband bathed us both. We sat side by side on the couch, watching the world move forward while we remained still. In those moments, I was given a glimpse—however brief—into my daughter’s daily reality. The difference, and the agony, was knowing that my condition was temporary, while hers would continue to decline.
That is where resilience truly revealed itself. In choosing surgery while parenting a dying child. In allowing myself to be vulnerable and dependent. In holding the grief of what is temporary for me and permanent for her. Resilience is showing up to life scared, sad, and lost—and moving forward anyway. My bilateral mastectomy was not just a medical decision. It was my way of choosing to stay, for as long as I can, for the children who need me here.
I practiced resilience by making a decision (vs being paralyzed in fear/denial). I considered all the factors that would impact my health- a child in hospice, two other children, a career, and thinking of what it would be like to get cancer/chemo.
There is no ONE correct answer on how to proceed in thinking about breast cancer prevention – surgery vs observation. Everyone will have an opinion, and the only opinion that matters is yours.
Are you ready to share your story of RESILIENCE? You can do that HERE.