Inheritance

My father used to joke that the strong resemblance between the women in our family hints that men had no involvement in our creation. When I was eight or nine, there were four generations of women still alive - my great grandmother was a redhead before her hair turned grey, my grandmother kept her black hair for most of her 78 years, my mother was a brunette until a recent decision to lighten things up, and I am a (now chemically-enhanced) blonde. But we all look remarkably similar - same noses, same foreheads, similar mouths.

The first thing most people asked when I told them my diagnosis is “does it run in your family?” I understand why – before I had to become an armchair expert overnight, I also thought that not having much of a family history meant I had very little risk.

But experts believe that only 10% of all breast cancers are hereditary. All cancers are related to the genes, but most are “sporadic” – it’s impossible to determine why the genes malfunctioned.

But as our family photographs prove, the gene pool does not lie. I received the results of my genetic testing yesterday, and I tested positive for the BRCA1 gene.

This does not come entirely as a surprise. My grandmother had breast cancer at the age of 76, which is so late in life it is not even considered "family history," especially since women's lifetime risk is as high as one in nine. But she had a hysterectomy in her 30s, and ovarian removal could have put off the onset of the cancer. It could also have come from the other side of the family - although there are so few women on my father's side that it's hard to identify a clear pattern, the gene can manifest itself in men as skin cancer, which has plagued his uncles.

In a strange way, the news is almost a relief. There are far fewer questions about a treatment plan - I will have chemotherapy, followed by a bilateral mastectomy and reconstruction using implants. And at least I know why this has happened to me at the age of 33. It also makes it easier to answer seemingly innocuous questions like "does it have to do with diet?" (to which I occasionally want to respond, "You know, you're probably right - if only I hadn't eaten those 5 cheeseburgers the summer of 2003!")

I don't really resent the questions, though, because I understand the need to lay blame, the comfort in theorizing how to avoid it. I played the same game when I got my diagnosis - I immediately started trying to figure out "what I had done wrong." Which is ridiculous, because if we could isolate that, then we'd be a lot closer to a cure than we are today.

No, all I did was to be born into my family, which is something I would never change. Sure I inherited the gene. But I also inherited my mother's writing skills and singing voice, my father's intellectual curiosity and debating ability, my grandmother's energy and analytical business mind, and my grandfather's love of family and joy at starting new projects. I am what my family has made me, imperfections and all, and for that I am truly thankful.

Best wishes for a wonderful Thanksgiving to you and your families.