Ultimately, my decision to have the prophylactic mastectomy was driven by many factors being stirred together in one big cauldron of breast stew. The first and most important factor was a desire to make a real and substantial dent in my breast cancer risk. Without breasts, not only will I be freed of the need for regular mammograms and biopsies, but I will also instantly lower my breast cancer risk by about 98 percent.

Buff's comment when he heard that was, "Wow, the surgery seems kinda like a no-brainer, doesn't it." But of course it's not—because they're not his breasts; they're mine. And because we're talking about lopping off ostensibly healthy breasts.

Well, at least for now they're still healthy.

The second factor in this decision was that, remember, I not only have a mother who survived breast cancer, but my father lived through his own breast cancer as well. This makes oncologists pay attention, as there tends to be a genetic component to male breast cancer.

The third factor was my having been diagnosed, as I mentioned, in September 2004 with hyperplasia with atypia, which is another breast disease that can increase the risk for breast cancer. This meant that the increasingly unbearable yet mandatory biopsies could be a necessity every year, in perpetuity.

The final, deciding factor came several weeks after my last biopsy. After the breast had been excruciatingly aspirated for three weeks and the swelling had gone down, I was horrified by what remained of my left breast. It was perhaps a half-cupsize smaller than the right breast, with a huge scar to boot. My left breast had literally collapsed on itself.

I couldn't even stand to look at myself in the mirror. We may take them for granted or stuff them into bras that don't quite fit, but breasts are such a huge component of who we are as women. Even with all the trouble they'd given me of late, I liked my breasts. They'd fed my babies. They'd made me feel sexual. They were an integral part of my body.

I felt cheated. I led a healthy life, kept my weight in check, didn't overeat or drink too much or smoke or go in the sun or have any other self-induced risk factors, and yet here I was with these pesky and no-longer-perky breasts giving me hell.

I stirred the cauldron some more, and then it hit me—Buff may well have been right. Seems like a prophylactic mastectomy could be a no-brainer after all.


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