Confronting a Family History of Breast Cancer, a Surgeon Makes Radical Decision

Faced with a family history of breast cancer, a surgeon makes a tough decision.

ByKatie Kindelan and Emily O'donnell
June 01, 2011, 8:19 AM

June 1, 2011 -- Dr. Christine Teal, chief of breast surgery at the George Washington University Hospital in Washington, D.C., has spent her career navigating women through the most difficult moment in their lives -- a diagnosis of cancer.

But it was her mother's second diagnosis of breast cancer last year that spurred Teal to make her own life-altering decision. Teal decided to undergo a double mastectomy in her 40s, even though she had no cancer in her body.

"It was the aggressiveness of my mother's cancer," Teal explained today on "Good Morning America." "My mother did everything right. She took Tamoxifen, which is supposed to lower your chance of a recurrence. She did all of her screenings."

Teal's decision to undergo a double mastectomy, even though she does not have cancer and has not been tested for BRACA, frequently called the breast cancer gene, strikes many as extreme.

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But it is an ultimate "What would you do?" question increasingly facing women today, 12 percent of whom, according to statistics, will develop invasive breast cancer over the course of a lifetime.

"It's very personal," Teal said of her decision to undergo the surgery, which is 90 percent effective in preventing the disease. "It's not right for everyone."

A Personal Journey

Teal's journey began in November 1997 when her mother, Nancy Brown, was diagnosed with a low-grade invasive ductal carcinoma in her left breast, a nonaggressive form of breast cancer that was treated with radiation and the drug Tamoxifen.

A month after her mother's diagnosis, Teal got a call from her best friend, Laurie, with news that she, too, had the disease.

Then in June 2010, the family's worst fears came true.

The cancer had re-emerged in Teal's mother, this time in her right breast. A mammogram, ultrasound and BRCA gene test didn't show any sign of the cancer, leaving it only to an MRI at Teal's hospital, George Washington, to confirm the diagnosis.

"Honestly, I don't know if I would have done it if my mother's second cancer was not as aggressive," said Teal. "The fact that we couldn't even see it on an X-ray or mammogram but had to do an MRI, that really got to me."

At the same time, Teal, a married mother of three young children, also learned that her great-aunt had died of breast cancer in her 50s.

Despite Tests, A Radical Decision

When testing for the breast cancer gene, doctors test the affected family member, in this case Teal's mother, first. Because her mom tested negative for the gene, Teal was never tested herself.

Teal had seen and been through enough with her mom and best friend, however, to conclude that a mastectomy, the removal of both her breasts even though she had only a 50-50 chance of ever getting cancer, was the right decision for her.

"I had a strong family history of breast cancer," Teal told "GMA." "The screening process is supposed to catch cancers early, but it didn't in my mother's case."

""I looked at my next 30 years of screening. Did I want to go through that?"

And so began Teal's life-changing journey, one in which she turned the cameras on herself, allowing George Washington Hospital to document her ordeal on film as she went from doctor to patient.

Teal checked herself into George Washington last January for a "bilateral prophylactic mastectomy," the medical term for a double preventive mastectomy. In the same surgery, doctors would begin breast reconstruction by inserting expanders.

"I woke up ... and I was like, what did I do," Teal said, recalling her immediate post-surgery feelings. "But I just feel total relief. I have no regrets at all."

Her family was also relieved, having stuck by her side even when Teal's own colleagues at George Washington, especially male doctors, who didn't understand the stress of breast cancer screening, questioned why she would take such a radical step.

"The 'what if' can be a tough thing to live with," said Teal's husband, Dave. "So this is something she wanted to do, and right away, I wanted to support her."

Teal's extended family, including her mother and aunt, were the spurring factors in Teal's decision to have a mastectomy, but her immediate family, her children, were the reason Teal chose to undergo the surgery now, in her 40s, as opposed to waiting until she was older, or until cancer struck.

"My kids are young now, and oblivious," said Teal. "My daughter, right now, all she cares about is that I was home for a month and could meet her at the school bus."

"I have the luxury of control and got to choose when the best time to do this is," she said. "When you have cancer you don't get that. Cancer takes control."

Lessons Learned

Teal says her mother is as good an example as any that even the best preventive screenings do not catch everything.

"Women need to know that even if you're BRCA negative, that is not a guarantee that you don't have a breast cancer gene," she told "GMA." "It's possible it just hasn't been identified."

Teal returned to the hospital May 25 for the last leg of her breast cancer journey, the removal of her expanders and the placement of implants to complete the breast reconstruction.

"I feel great. I feel much more natural," Teal told "GMA" today. "I'm just ready for the doctor to say I can start running again."

And she's ready to get back to her patients who face breast cancer, for whom, having now been a patient, she has newfound respect.

"I thought I knew what my patients went through," Teal said. "I had no idea. I learned a lot.

"So many people have said that I'm brave," she said. "But it's all the patients who are living with cancer who are brave. They're the ones who are going to have to live with it for the rest of their lives.

"I'm the lucky one."

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