Written By Robin Warshaw, Contributing Writer
Reviewed By Susan M. Domchek, MD
Because her mother and maternal aunt had the BRCA1 gene mutation that increases breast cancer risk and also were diagnosed with breast cancer, Oliviya Daugherty, of Rifle, Colorado, knew she should have genetic testing. Yet she delayed.
“I had just had my [first] baby, so I was out of my mind,” she says. “I was focused on him and on my mother’s recovery [from breast cancer].”
When her son was 9 months old, Oliviya became pregnant with a girl. Her aunt died from breast cancer right before the new baby was born. “Wanting to know for my daughter really drove me to get tested,” Oliviya says.
The genetic test came back positive. Oliviya, too, had the BRCA1 mutation.
Understanding Genetic Risk
When Oliviya received her test result, she became concerned about her future and her children’s futures. She wanted to know more about their risk of developing breast cancer.
A few months later, she attended a conference sponsored by FORCE (Facing Our Risk of Cancer Empowered), an organization focused on hereditary breast and ovarian cancer. She learned how some women with strong genetic risk have both of their healthy breasts removed before cancer could develop, a procedure known as prophylactic, or preventive, mastectomy.
“I was all excited about it,” says Oliviya. “I could do something in my power instead of sitting around and waiting for something to happen.”
On returning home, she found a plastic surgeon to do the prophylactic double mastectomy. The doctor ordered a mammogram, but her insurance company refused to pay for it.
The insurer was clear about why it wouldn’t pay for the test despite Oliviya’s genetic risk. She was only 27. According to the insurance company, she was too young to need a mammogram—even though women with BRCA1 or BRCA2 mutations are up to seven times more likely to be diagnosed with breast cancer than other women.
High-risk women like Oliviya are recommended to begin breast screenings at age 25. Many receive insurance approval. If they are declined, physicians can talk directly to insurers to explain the need.
Oliviya looked to get a mammogram elsewhere, but she was turned down. Finally, she went to the local Susan G. Komen for the Cure affiliate, which covered the cost. The mammogram showed a dark spot.
She had a biopsy that same week, on Friday. “I waited the whole weekend,” she says. The call came at dinnertime on Monday. She had breast cancer.
By the time Oliviya had a double mastectomy, it wasn’t to prevent breast cancer; it was to remove it. She had stage II, hormone-positive, HER2-negative disease.
Dealing With Loss
Oliviya chose to have a DIEP flap reconstruction, which uses skin and fat to rebuild the breast mound. As Oliviya was beginning chemotherapy, her mother found out that her breast cancer had metastasized, or spread, to the bone. “I was caring for her,” Oliviya says. “We were doing chemo in the same hospital, on opposite days.”
While Oliviya was still in chemotherapy, her mother’s condition declined and she died.
“I think I just shut down and put one foot in front of the other,” Oliviya says. “My kids were a huge part of it. They were why I got out of bed every morning. They still needed a mom. It was pretty hard.”
After chemotherapy, Oliviya had surgery to remove her ovaries. Treatment ended two years ago, but she has long-term side effects, including severe neuropathy in her arms and fingers, depression and early menopause symptoms such as hot flashes and weight gain. “I had a dozen surgeries, chemo in my body and I was sick of it—sick of how it made me feel,” Oliviya says. Oliviya uses aromatherapy to help relieve side effects.
To protect her family from further possible cancer risk, Oliviya avoids heating plastic containers, chooses hormone-free foods and shuns pesticides by buying organic foods. She volunteers at a local Susan G. Komen for the Cure race and speaks to young women’s groups. “I tell them cancer is not age-biased,” she says. She plans on encouraging her daughter to be tested at age 18 (testing for boys with family history is recommended as well).
For now, Oliviya and her family enjoy small-town life in the Colorado mountains. They have a horse, two miniature donkeys and a boat they take to a nearby lake.
“I don’t obsess over breast cancer,” Oliviya says. “I don’t let it ruin my day.”
This article was supported by Cooperative Agreement Number DP11-1111 from The Centers for Disease Control and Prevention. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention.