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March 20, 2008

Breast Cancer Risk: Cutting My Losses

Q & A with writer Jessica Queller, whose breast-cancer-gene mutation test results led her to make a remarkable decision.

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Photo Credit: Ben Goldstein/Studio D

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In 2004, one year after her mother died of cancer, 34-year-old Jessica Queller got tested for the BRCA breast-cancer-gene mutation. The results showed she had an 87 percent chance of developing breast cancer in her lifetime and a 50 percent chance of it happening before age 50. Even though there were no lumps to speak of, Queller, now a writer for Gossip Girl, made the remarkable decision to undergo a prophylactic double mastectomy. In her new book, Pretty Is What Changes, she tells her story.

MC: Why did you get tested?
JQ: My mother had both breast and ovarian cancer — a warning sign for the BRCA gene. I thought, It's time to renew my driver's license, I have to get my teeth cleaned, and I need to get that test. It was just another thing on my list — but it took me three years to make the appointment.

MC: What was your reaction when you got the results?
JQ: I took the test without seeing a genetic counselor first, which is the wrong thing to do. So I just thought a positive meant I'd have to get screened more often. Three months later, I had this nagging guilt that I was ignoring the issue, so I set up an appointment with a genetic counselor. She said I should consider getting a prophylactic mastectomy and have my ovaries removed, the gold standard of preventing the disease. I thought it was outrageous. Why would a youngish single woman without cancer choose to remove her breasts? It felt like I was living in a scary sci-fi movie — the idea that my own body, my own breast tissue, could potentially kill me. This was 2004, when most people had never heard of this test.

MC: What, beyond the obvious, were your fears?
JQ: I worried there might be a cure for breast cancer in the next 10 years. But the more I spoke to doctors, the more I realized that if I waited, I would be taking a big risk. I don't have a gambler's temperament, and I certainly didn't want to go through what happened to my mother. So I had the surgery.

MC: And you were single and dating. What was that like?
JQ: I tended to be pretty up front about it. My boyfriend at the time didn't care at all; he would've stuck by me, but we split up for other reasons. Several new men were put off by the news, and I didn't get asked out on many second dates. I guess it's not the sexiest thing to say, "I'm about to remove my breasts."

MC: What was it like writing for frothy shows like Gilmore Girls and Gossip Girl while going through all this?
JQ: I think what was happening in my personal life gave me healthy perspective in the workplace. Even though the stories on the shows can be kind of silly, the work environment is incredibly stressful and filled with politics. My health issues helped me have a sense of humor about all that.

MC: And you're trying to have a baby?
JQ: I researched 50 sperm donors and have finally chosen one. I need to have my ovaries removed in two years because of this gene. I couldn't go on a date and say, "Are you ready to get me pregnant in three months?" So I decided to have the baby by myself and then let love happen as it happens.

MC: Would you advise other women in your position to have the surgery?
JQ: Yes, because it turns out I did the right thing — the pathology report showed precancerous changes in one of my breasts.


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