Mastectomy at Age 21: My Breasts Were Ticking Time Bombs

8 Nov 2013 at 9:00am

by Rachel Joy Horn

pencil erasing the word cancerRachel Joy Horn is an Associate Editor for and author of Ticking Time Bombs, a blog focusing on young women at high risk for breast cancer. This is her mastectomy and breast reconstruction journey. In her own words.

In 1999, when I was 9, we moved to Northern California from Boston for my mother’s job. Just a few short months after the move, my mom discovered a lump in her left breast. A biopsy confirmed it was breast cancer. Mom was 46. She opted for a lumpectomy, chemotherapy, and radiation. Breast cancer didn’t mean much to me at the time. The only trauma I felt was when a classmate asked why my mom was bald.

rachel joy horn age 9

By the time I reached middle school, breast cancer was a thing of the past. Mom was once again healthy and active, participating in charity walks for cancer research (and even spent a week in Peru hiking the Inca Trail for her 50th birthday). I participated in my first breast cancer charity walk at age 16. I felt blessed that my mother was a survivor.

My parents moved to sunny California in July 2011, before my senior year at the University of Southern California. They cited the proximity to excellent medical care as a reason for their move. My dad is a diabetic and suffers from congestive heart failure.

rachel joy horn mastectomy usc graduation

But Dad wasn’t the only one to benefit from the nearby hospitals: just one month after the move, my mom’s routine mammogram revealed a spot on her left breast.

It was breast cancer—again. This time, I wasn’t the blissfully ignorant kid; I was a fearful and angry adult.

Why did my mother have to suffer the same fate twice? My question was answered by a blood test: my mom had a BRCA gene mutation. On November 9, 2011, she had a double mastectomy with reconstruction.

rachel joy horn with her mom before her mastectomy

There was a 50 percent chance that I had inherited my mom’s BRCA2 mutation, so I contacted her genetic counselor to be tested. On October 25, the results were in: I had the mutation. Immediately I felt betrayed by my body. On the outside I was still a normal girl, enjoying Halloween with my friends and boyfriend, but on the inside, I felt like cancer was waiting to happen.

rachel joy horn adam and eve costume mastectomy

I knew my options: surveillance or surgery. Many high-risk women choose surveillance, but the way I saw it, surgery was a way to beat cancer to the punch, so I decided to have a prophylactic double mastectomy. But before I did, I said “goodbye” to my breasts with a bang. I went to a Coldplay concert. I went to Vegas. I even threw a party, Breast Fest 2012.

rachel joy horn with friends mastectomy

My nipple-sparing mastectomy was March 13, 2012. I was 21. Immediately after waking up in the recovery room, I felt a sense of relief. Yes, my breasts were gone—replaced by tissue expanders, the first step in breast reconstruction—but more importantly, my risk of breast cancer was greatly reduced.

rachel joy horn brca gene double mastectomy

Reconstruction wasn’t exactly easy. I developed a cellulitis infection, resulting in the temporary removal of my left tissue expander. For three months, my right breast was filled with over 500 ccs of saline; my left breast was virtually non-existent. But I made do with a prosthesis and a smile—my mom even made a mastectomy bikini!

rachel joy horn mastectomy bikini

November 19, 2012 was my implant exchange surgery. My tissue expanders were swapped with 800 cc silicone implants. Sure, they’re not my “real” breasts, but they're perky and surprisingly soft. 

rachel joy horn after mastectomy and breast reconstruction

It was worth it, knowing I stopped breast cancer before it could stop me.

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