Ten years later, a malignancy recurred in the same breast, and Gail knew that her only option was a mastectomy. She was stunned, however, at her doctor's suggestion that she might want to have her other breast taken off as well.
"It was a shock," Gail says, "almost too much to absorb. I sat in the doctor's office and I felt as though he was talking through me, not at me. The thought of losing two breasts was devastating."
Gail has a lot of company. According to oncologist Morton Kahlenberg, a spokesperson for the American Society of Clinical Oncology, from l00,000 to 125,000 women in this country undergo mastectomies each year. More women are having them to prevent future cancers because, like Gail, they are genetically vulnerable and cannot tolerate the anxiety of waiting until they feel the dreaded lump or for the mammogram that may reveal a cancer.
However, according to a study reported at last year's conference of the American Society of Breast Surgeons, only 20 percent of eligible women choose to have breast reconstruction despite legislation requiring that insurers cover the surgery. Some women don't want to undergo another procedure; others, especially those who don't live near major medical centers, are not offered the option.
In Philadelphia, Gordon F. Schwartz, director of the Breast Care Center of Thomas Jefferson University Hospital, says 90 percent of women he treats with mastectomies choose reconstruction. Oncologist John Glick of the University of Pennsylvania's Abramson Cancer Center says his practice is to refer all women, with their permission, to a plastic surgeon so they know the options: "No one should do without reconstruction because she hasn't been educated about that choice."
