What would you give up for the sake of your child?
Last summer, at the age of just 31, single mother Kate Maddison Greenwell sacrificed both her breasts.
Radical though it was, it was one of the easiest decisions she has ever had to make.
Kate had discovered she was carrying a mutant gene called BRCA1 – which meant she had an 85 per cent chance of contracting breast cancer and a 55 per cent risk of ovarian cancer.
And as the mum of a seven-year-old, those odds were way too high for her to live with.
To increase her chances of living to see her little boy Joshua grow up, she elected to have a double mastectomy.
Six months on, she is still recovering from complications caused by the surgery. Her body will never look the same again and she still needs another major operation to reduce her risk of ovarian cancer.
But as far as Kate is concerned, it has been a massive success. It has reduced her chances of getting breast cancer so dramatically, she now stands the same chance as the general female population.
“You know what? I just feel so lucky,” she says.
I’ve been able to do something about bettering odds that were hugely stacked against me. My risk of getting breast cancer is now just five per cent.
“There is a very strong chance I will live healthily to an old age and see Joshua grow up.”
That was something she had always taken for granted until the day in November 2011 when her dad sat her down to give her shattering news.
His niece Michelle had just been diagnosed with breast and ovarian cancer. Tests had revealed she had a defective family gene, BRCA1.
“Dad’s mother and grandmother had both suffered from breast cancer in an era when that was considered bad luck rather than an indication of a predisposition passing down the family line,” she says.
“Now breast cancer scientists know differently. My cousin Michelle, who lives in America, had inherited the family gene and contracted cancer. Doctors had urged her to contact all her relatives in the UK and warn them they could be at risk.
“I was really shocked; Michelle was only in her 30s, just a few years older than me.”
Kate was the first of four women on her side of the family to have the tests.
“It all felt overly dramatic,” she recalls. “I was perfectly healthy; I wasn’t being tested to see if I had cancer, which was how other people saw it; I was being tested to see if I was likely to contract it in the future,” she says.
The verdict came just weeks into 2012. Out of the four, Kate was the only one who had the BRCA1 gene.
She says: “I could have elected to go for yearly cancer screening but I had to lessen the odds, for Joshua’s sake. I decided on surgery.”
Before the lengthy and complicated operation to remove both her breasts, Kate received psychological counselling: “There were issues I needed to consider, like how would I feel about my body if I got into a new relationship?
“But I kept going back to that 85 per cent. The risk of getting ill and not being able to support my son physically and financially, or worse, the thought that I might die and leave him to cope without me, that was so much more daunting.”
Weeks before her op at Sheffield’s Hallamshire hospital, she broke the news to her son. She says: “I explained I was going to have an operation to stop me from being poorly in the future. The thing that worried him the most was that we wouldn’t be able to cuddle afterwards. “We decided that we could make do by hooking our little fingers together into a finger cuddle,” she grins.
Then she hired a function room and invited her friends to a Bye Bye Boobies Party to bid her 38DDs farewell. There was even a boob-shaped cake.
“When the day of the operation and reconstruction came I didn’t feel particularly sad at the impending loss of my breasts,” she reflects.
Recovery was swift – she was back at work in five weeks, despite the wound on her right breast refusing to heal. And her attitude is amazingly philosophical.
“I have never felt bitter; it’s no one’s fault. You have to take what life throws at you,” she says. “I feel blessed because I got the chance to do something about it, thanks to my cousin Michelle, who is now in remission, and to the wonders of medical science.
“There are millions of people walking around with an increased risk of getting cancer because of their genes, who won’t know until it happens to them.
“Most of the women on my ward were having surgery because they had just found out they had breast cancer; they were incredibly frightened and after their operations the shadow of cancer was still hanging over them. They all said they would have done what I had done had they been given the chance.”
There is still an increased risk Kate could contract ovarian cancer; she is waiting until her body has fully recovered before deciding whether to have a full hysterectomy or the removal of her ovaries. She has become passionate about encouraging other women who may have a hereditary risk of cancer to take the test. “I couldn’t find any support other than that given by the doctors and nurses. My ultimate aim is to set up a support system for women who have, or think they have, the BRCA genes and are trying to decide what to do,” she says. “Many choose to stick their head in the sand and think: when I get it, I’ll deal with it.
“I can understand where they are coming from, but I believe they don’t know there are options that could change their destiny. There are a lot of very scared women out there.”
Of all women who develop breast cancer, about 1 in 5 has a significant family history of the disease, says Breakthrough Breast Cancer.
Of these, around a quarter – 2,400 patients each year – have inherited faults in the breast cancer genes BRCA1 and BRCA2.
Women who know there is a history of breast and ovarian cancer in the family are urged to go to their GPs with as much information about their family’s history as possible.
Derbyshire woman Wendy Watson, the first British woman to have a pre-emptive double mastectomy, and her daughter Becky Measures, who had the same surgery 13 years later, run the national 24-hour Hereditary Breast Cancer Helpline on 01629 813000, www.breastcancergenetics.co.uk