This story begins in early December 2011. I had received a diagnosis of ductal cancer in situ (DCIS), a noninvasive cancer staged at 0 in the ducts of my left breast (National Cancer Institute [NCI], 2009). The breast surgeon from whom I was obtaining a second opinion discussed lumpectomy versus mastectomy and radiation. Toward the end of the visit, the surgeon suggested that I have a laboratory workup for vitamin D levels. Vitamin D has been found in some studies to reduce breast cancer risk, and levels of vitamin D also have been found to be low in women with breast cancer (NCI, 2012b). I was directed to the laboratory area. Suddenly, the surgeon burst in and announced that no BRCA results were on file at my gynecologist's office. She informed me that if I carried the genetic mutation, "You will need to have a bilateral mastectomy and salpingo-oophorectomy." The BRCA1 and BRCA2 genes (breast cancer susceptibility 1 and 2) usually shield women from certain cancers; however, if these genes possess mutations, the risk of hereditary breast and/or ovarian cancer is greatly increased (NCI, 2012a). A pamphlet produced by Myriad Genetic Laboratories (2009) states that those women with BRCA mutations have:
• As much as a 50% risk for developing breast cancer by age 50 years.
• As much as an 87% risk of developing breast cancer by age 70 years.
• As much as a 64% risk of developing a second breast cancer.
• As much as a 44% chance of developing ovarian cancer by age 70 years.