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'Because of me, she had to go through this'

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She winced as her daughter struggled with pain and waves of nausea.

Tubes came out of her body and bandaging covered her chest.

Rhonda Muncy knew what her daughter was feeling. She underwent a double mastectomy earlier that year and remembered well the pain and discomfort after surgery.

But seeing her daughter in pain was made worse by the unrelenting thought that it was her fault.

Brittany Muncy wouldn’t have had to undergo a double mastectomy as a senior in college if she hadn’t had the genetic marker that made her up to 85 percent more likely to develop breast cancer.

In her mother’s mind, that made this painful process her fault.

“It was really hard for me, too. Because of me, she had to go through this,” Rhonda Muncy said.

For Brittany Muncy, 22, the pain and nausea were bad. But the worst part was seeing her body after the surgery. She looked away when her mother changed her bandages or checked her drainage tubes. She just couldn’t watch.

She knew the surgery and recovery would be difficult, and at times Brittany Muncy considered not doing it.

But then she thought about all the tests she would have to go through — a physical exam, mammogram and breast MRI once a year. She imagined how she would feel waiting for those tests to come back every time.

“I felt like I would have to live my whole life being afraid,” Brittany Muncy said.

And her mother talked to her about how busy her life would become after she graduates from Franklin College next year, when she will be looking for jobs and starting a career.

After some convincing, Brittany Muncy agreed now was the time, giving her mother a sense of relief.

As genetic testing for breast cancer has become more common, so has the choice by women — including women as young as Brittany Muncy — to get a preventive double mastectomy.

For the Muncy family, both mother and daughter were tested for the BRCA 1 and 2 genetic marker. When the test came back positive, that meant that the cancer was hereditary. That gave Brittany Muncy up to an 85 percent chance of getting breast cancer and a 40 percent chance of getting ovarian cancer, said Dr. Erin Zusan, a surgeon at Community Breast Care who treated both women.

The results of the Muncy family are rare.

Of all the patients diagnosed with breast cancer, only 5 percent to 10 percent have a hereditary link, Zusan said.

Everyone has BRCA 1 and 2 genes, and if they are working properly, they don’t cause problems. But if there is a misstep or mutation in the gene, that makes the person more likely to get cancer in their lifetime, she said.

Only certain patients are tested. Rhonda Muncy was tested because she was 43 when she was diagnosed, and being younger than age 45 or pre-menopausal often leads to women getting tested, Zusan said.

Rhonda Muncy also did not know her mother’s family history because she was raised by her father and grandmother, she said.

She was grateful they could do the test and fill in the blanks she didn’t know. She didn’t want her daughter to go through what she had been through that year.

In January, she noticed a lump. She went to have it checked out, and two days later she was told it was cancer.

Within a matter of days, Rhonda Muncy was on a treatment plan. The cancer she was diagnosed with, invasive ductal carcinoma, had the potential to spread quickly, so treatment had to start immediately.

She started chemotherapy in February and had six five-hour treatments. She focused on handling it well, trying not to complain about the metallic taste in her mouth or her hands peeling. She had to stay strong for her family. If she was weak, she worried they would think less of her, she said.

And Brittany Muncy was there for every treatment except once, when she was sick and her mother wouldn’t let her go.

She was still in shock about the diagnosis, but she was not going to let her mother go to treatment alone, she said.

“You just never think your family is going to be the one it happens to,” she said.

Then, her mother’s doctor brought up genetic testing, saying the family should get tested. Brittany Muncy shrugged it off.

She let them draw her blood, but she didn’t think much of it. She wasn’t too worried, though there was a bit of fear of the what-if in the back of her mind.

“I thought, ‘Whatever, it won’t come back positive,’” she said.

But it did.

And then Brittany Muncy was the one who had to make decisions about treatment.

Patients don’t have to have a mastectomy just because they test positive, but many do because the risk of cancer is so high, Zusan said.

Other options include annual testing and preventive medication. The medication reduces the risk of cancer by about 50 percent but also brings on the symptoms of menopause, such as hot flashes, she said.

But surgery isn’t always ideal, either.

 Zusan said patients often talk to her about whether surgery is needed if they aren’t guaranteed they will get cancer.

Brittany Muncy asked that question and then learned about a patient who was diagnosed with cancer at 22, her age.

Zusan leaves the choice to her patients, but she does talk to them about the benefits.

“I do encourage them to remember surgery. It’s a way to be proactive about their health. That way they have some control over what is usually an uncontrollable situation,” Zusan said.

Zusan also recently has been able to offer a new surgical option to patients with smaller breasts. The surgery to remove the breast tissue includes only an incision beneath the breast, known as nipple-sparing surgery because it does not require cutting the nipple and areola, she said.

After surgery, the scarring is much less, appearing as if a woman has had breast implants, rather than a mastectomy, she said. Doctors are working on finding ways to do the surgery on women with larger breasts, she said.

Knowing that procedure was an option eased Brittany Muncy’s mind because she had been worried about getting scars. And now, the scarring would be much less.

She was self-conscious about the surgery, worried that when she got back to campus people would know. Plus, it was her first surgery.

Her friends tried to get her to see a bright side. The day she told her roommate about the positive test, her roommate piped in that she could finally get breast implants. And Brittany Muncy had to laugh.

She told her mother, and they both decided that would be their positive spin.

“It’s something I always wanted to do. This is just a harder route,” Brittany Muncy said.

They also believe the experience has brought them closer together.

Brittany Muncy moved back home for a few weeks after surgery, and now they go to appointments to have the expanders in their breasts filled at the same time. Both will have one more surgery this fall to finish their reconstruction.

And Brittany Muncy eventually will need to think about having the surgery her mother did to have her ovaries and fallopian tubes removed, but not until after she has the chance to start a family.

Both look back on the past year as a whirlwind of emotions and stress.

“I never expected me to have it. Then her,” Rhonda Muncy said. “I didn’t want her to have to go through any of it.”

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