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Preventing breast cancer the hard wayWoman at high risk chooses elective surgery
By A. Chris Gajilan
(CNN) -- Some might think 49-year-old Denise Barickman is crazy. Some might say brave. She had both her breasts and her ovaries removed earlier this year. Breast cancer is the second-leading cause of cancer death in American women, behind lung cancer. More than 200,000 American women are diagnosed with breast cancer each year. But Barickman has never been diagnosed with cancer. After having two benign lumps removed, she had her procedures done just to play it safe. Breast and ovary removal as a means of prevention is rare. "I had never heard about what she had done before she told me, so I was pretty surprised," said Jackie Barickman, Denise's 19-year-old daughter. Barickman, of Port Orange, Florida, describes the first time she approached her doctors: "I walked through the door and shook his hand and said, 'I'm not here because I'm sick, I want to stay well. This is a wellness visit.'"
Nearly three quarters of women know someone who has been diagnosed with breast cancer, but for Barickman, the disease hits closer to home. She has watched family members battle cancer throughout her life. Her mother was diagnosed with breast cancer 30 years ago and had a radical mastectomy. Two of her sisters are also breast cancer survivors, and another had colorectal cancer. "She was just an emotional wreck just thinking about what her risks were," said Dr. Neil Finkler, Barickman's physician, a gynecological oncologist. "People who have family histories like Denise live in fear on a daily basis that their day is one day from being just like their family members." In the United States, one out of eight women will develop breast cancer. But according to Barickman's doctors, her risk of developing breast cancer was almost four times the average. Her risk of getting ovarian cancer was 15 times greater than average. Despite the heightened risks for women like Barickman, surgery is a difficult decision. "Of those who might even know that they have a risk, it's often less than half that do anything proactive about it," said Dr. Rebecca Moroose of the Florida Hospital Cancer Institute. Dr. Louis Barr, Denise's surgeon, recognizes the hard decisions women face. "It's a significant thing to undertake; it's irrevocable. There's no way to hide it. There's no way to go back," she said. Barickman talked to her sisters, researched her options on the Internet and made a plan. "By the time I had made this decision, you know, in my mind, my breasts were not very pretty-looking," Barickman said. "Because I felt there was something lurking inside that was going to kill me." After deciding on the surgery, Barickman had to discuss it with her family. "It was a surprise to me, so I questioned whether she had really thought it through at that point," said Barickman's husband, Mike. "It took a while to come to the realization that even though we have a partnership, that is a decision that you have to make yourself." After the surgeries, Barickman's risks for breast and ovarian cancer dropped to near zero since some breast tissue might be left behind. Barickman said she knows she made the right decision. "Even though I have a scar right now, I'm happy to have everything done. Like I said, I'm at peace now." Barickman is scheduled to have breast-reconstruction surgery. She said she would remind women that when it comes to their health, they do have choices.
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