Pittsburgh-area woman made similar decision long before Jolie
By Luis Fábregas
Published: Saturday, May 18, 2013, 12:01 a.m.
Rachel Golden believed it would be only a matter of time before doctors found cancer in her breasts.
Not only did her two grandmothers have the disease, but Golden carried the so-called BRCA-1 gene mutation that gave her an 87 percent risk of developing breast cancer at some point in her life.
In November 2006, the young mother from Mt. Lebanon chose to have a double mastectomy. She willfully gave up a part of her body to reduce the chance of getting an illness that kills more than 40,000 women in the United States every year. She knew the odds, and they weren't pretty. Something had to be done.
“It was a small price to pay,” said Golden, 38, a former accountant who is now a full-time, stay-at-home mom to three girls. “There was a probability that at some point my fear would be a reality.”
Golden was years ahead of Angelina Jolie. The movie superstar disclosed this week that she had an elective double mastectomy because she carries the same gene mutation and her own mother had died of the disease at 56. She did so in a stunningly candid opinion piece in The New York Times that quickly went viral and had the medical world abuzz.
Golden was equally frank when we spoke, revealing that she never thought much about breast cancer despite her family history. One of her grandmothers is still alive. The other lived more than 40 years after her breast cancer diagnosis.
But her brother's mother-in-law is a genetic counselor who encouraged Golden and her three sisters to undergo testing for the gene, which is commonly found in Ashkenazi Jewish families such as the Goldens.
When Rachel's test came back positive, doctors eventually spotted one minor irregularity in her cells they said wasn't tied to cancer. But it was enough for Golden, after serious discussion with her husband, to opt for the mastectomy.
“I couldn't deal with the mental anxiety of not knowing whether I was healthy or not healthy,” she said.
Golden's ordeal illustrates some of the complex layers of an all-too-real dilemma for women at risk of this devastating illness. They face questions that invite labyrinthine answers. Do they minimize the risk as much as they can, or do they wait and choose newer drugs that might or might not reduce their chances of developing cancer?
The answers aren't easy because even women with a history of breast cancer in their families face varying degrees of risk, Dr. Thomas Julian, associate director for Allegheny General Hospital Breast Center, told me. Further, even when they opt to go for a preventive or prophylactic mastectomy, they might later decide it wasn't the right path. He mentioned cases in which women felt like a different person or less feminine after the surgery.
The best lesson we've learned from this renewed conversation is the certainty that knowledge is power. As Dr. Julian told me: “One should never go into this in a dark mode with blinders on.”
It's too early to know if Golden will push daughters Emily, Maya and Sidney to get tested for the gene, because they are too young. Her only hope is that by the time that conversation arises some 10 years from now, women will have more options.
“Maybe a way to repair the mutation or a cure for breast cancer?” she said.
Luis Fábregas is a staff writer for Trib Total Media. He can be reached at 412-320-7998or firstname.lastname@example.org.
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