Confessions of a Breast Cancer Previvor

The complications of my preventative mastectomy were far deeper than I expected

Journalist Sonali Kolhatkar got a preventative double mastectomy due to her family’s cancer history

What have I done? The thought flashed in my mind like an unrelenting neon sign on a dark night. I was sitting on the edge of a hospital bed, body bound with bandages. A mummy. Living dead.

It was December 15, 2016, my first day as a “cancer previvor,” and a few weeks after Donald Trump won his first presidential election. While I, as a professional journalist, was called upon to cover the unfolding national political disaster, my own personal shitshow was taking center stage in a Los Angeles hospital room.

A year earlier, when the call arrived with the results of my DNA blood test, I braced myself. “You have the BRCA1 gene mutation,” said my genetic counselor, softly and with an appropriately sober tone. My legs gave way and I sat abruptly. “This means your lifetime risk of breast cancer is 87 percent,” she added slowly.

I instantly grieved for my husband and two children—an unusual thought considering I was the unlucky one, not them. But I know what it’s like to watch a loved one suffer and even die.

My mother has survived breast, neck, endometrial, and colon cancer. My aunt died of breast cancer at age 34. Both maternal grandparents were also victims of cancer: lung and throat. Our family history is littered with the barbaric impacts of chemotherapy, radiation, failed treatments, and fatal tumors. I couldn’t put my beloveds through the helpless pain of watching me suffer.

I’ve always been a doer. And sometimes I do before I think. I’ve steered my life by an instinct for doing the hard thing because I’ve guessed—often correctly—that it’s the right thing. And I’ve understood that stopping to consider all the possibilities could feed the fear that lurks inside.

I would act upon the medical intelligence my family members hadn’t been fortunate enough to access. Rid myself of my breasts. End them before they ended me.

“A prophylactic double mastectomy using a DIEP flap procedure” was how the plastic surgeon described one of the options available to me. Rather than silicone breast implants, I could have a brand-new rack formed from my own fat! And boy, did I have plenty of fat to spare. The surgeon pinched my ample post-childbirth belly with thumb and forefinger to emphasize just how much raw material she would have to work with.

Wait, what? New boobs made from belly fat?

It was an elegant cut-and-paste solution, one I quickly embraced. Not only would I avoid potentially messy, leaking implants, I’d get a free tummy tuck. I brushed aside concerns of numbness and complications of micro-surgery. I would turn my BRCA diagnosis into the ultimate vanity-fueled body hack.

“You’ll spend a lot more time in recovery, but it’s a permanent solution and you won’t have to worry about implants or cancer,” the surgeon explained, smiling confidently.

Yes, please!

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At the same time as Trump won the electoral college in 2016, Californians passed Proposition 64, legalizing recreational marijuana. I resolved to acquire some pot for unorthodox pain relief as part of my recovery plan.

I bought a power-lift recliner to sleep on while my abdominal incisions healed and ordered a post-mastectomy robe with pockets for the drain pouches that would be attached to me, one for each breast and one for each side of my belly.

A friend set up a meal train and I cooked and froze pots of chili and lasagna casseroles to supplement it.

I explained to my two young sons, then aged nine and four, what mommy was about to do and why.

I was ready.

My pre-surgery instructions included a thorough shower the night before. No products on my skin, and no food or drink.

I bade my nipples goodbye, which is a funny thing to admit. They had let me down after the births of both my children, refusing to shape themselves into adequate milk ducts, and causing endless frustration and post-natal trauma over nursing. But they were mine.

Women’s nipples house dense clusters of nerve endings. They offer a veritable bouquet of sexual sensations.

I still remember that last shower before surgery. Remember this. Remember what these wellsprings of delicious pleasure have given you. I etched the sensations into my brain.

The surgery was 13 hours long. A breast surgeon excavated all the breast tissue she could find, then handed the baton to a plastic surgeon. She in turn spent the majority of the operating time painstakingly carving fat from my lower belly and stitching its blood vessels into my chest to form new breast-like mounds that would take root on my upper half.

When I came to, my husband was by my side, haggard and worried and happy to see me conscious. Every hour, nurses came by with handheld ultrasound machines to ensure blood still flowed past the fresh internal stitches to keep the fat tissue alive. Bump-bump, like baby heartbeats in my chest.

A few hours into my recovery, my left side grew silent. The blood had stopped pulsing. If left unaddressed, the tissue would necrotize. I was wheeled back into the operating theater, and for another nine hours the surgeon cut and stitched to salvage her work.

When I awoke a second time, my husband was still there, paler and more stressed than before. My twin babies were bandaged upon my chest, their heartbeats strong. I tried taking a deep breath—and couldn’t.

My entire chest was ensconced in bandages. A large incision stretched from one side of my hip to the other, with more bandages sealing the wound. I was wrapped so tight I couldn’t fill my lungs to capacity. It felt as though someone dropped a piano on my chest.

A nurse encouraged me to get on my feet and relieve myself on my own. I dragged the intravenous drip tower connected to various parts of my fragile body into the toilet with me, one painful step at a time, not caring if the hospital gown concealed my backside.

Afterward, I sat on the edge of the bed, panting from exhaustion and fear and hunger. I hadn’t eaten for nearly 48 hours as surgeries need to be conducted on an empty stomach to avoid aspirating food during general anesthesia. Bile reared up in the back of my throat and I swallowed it.

I’ve always been a doer. But this time I wondered, What have I done? So much for an elegant solution to my BRCA diagnosis. Rather than embody a joyful middle-finger to cancer, I was the Bride of Frankenstein. I could barely take a breath, let alone enjoy the wonders of a cancer-free existence.

I wanted to turn back time, to return to the surgeon’s consultation room and choose another way. Maybe just let the cancer come and deal with it—as legions of women have done. Anything but this claustrophobia of bandages and incisions and blood and stitches.

Focusing on my predicament veered me toward suicidal thoughts. My heart beat faster but I couldn’t pull enough oxygen to slow it down. I was straitjacketed. Buried alive. My shallow breaths were ragged, threatening to implode.

I could panic and run screaming down the hospital halls, tearing off my bandages, rending open my fresh wounds, and jump out the window into the welcome arms of a quick death.

Or I could lock my terror within that box inside my brain, the one where I tuck away my deepest fears. Tamp it down. Jam it shut. And later, much, much later, ease it open and face it with a body that’s whole and healed.

Stop, stop, stop, I pleaded to myself. It’s too late. Step away from the abyss.

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When the blood flowing through my new breasts was stable and the surgery was deemed a success, I was cleared to eat. A nurse brought me breakfast. I ate it and promptly threw up.

Pneumatic compressors massaged my legs to keep blood coursing through my body as I lay prone and mentally detached. A pressure cuff squeezed my arm once an hour and a parade of nurses constantly checked my vital signs. Between drowsy binge-watching bouts of Gilmore Girls and vivid dreams brought on by potent painkillers, the days merged into nights, and time plodded miserably on. The box of panic remained hermetically sealed.

Close friends visited, horrified at my state. With my husband at home taking care of the kids, it was the nurses who offered me comfort and hope. They had cared for hundreds of patients, including many who had undergone the sort of complicated prophylactic mastectomy that I had. They had the benefit of second-hand hindsight. “I promise, in six months you’ll be so happy you did this,” said one. I latched onto that promise, an anchor in the squall.

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A week later I was home. I couldn’t even lift my arms, and so my husband bathed me, washing my long black hair. I should have cut it short before my surgery, I chastised myself. It was far cry from the pre-surgery shower during which I had enjoyed my last hours of nipple pleasure, unaware of the horrors I was about to face.

My belly button was higher than it should have been. My swollen breast-like appendages were conical rather than pendulous. My body was a Dali-esque distortion. I had chosen this mutilation.

As I lay on my recliner on that first night back in my own home, I decided to wrest control. This was still my body, dammit. Sliced open and patched into a vague semblance of a female form, but still mine. I’d weaned off the prescription painkillers, so I reached for the edibles I’d procured before the surgery and popped one perfect chocolate-covered blueberry into my mouth.

I waited for intoxication to eclipse my pain. But what came was more pain.

Cannabis is an excellent drug for heightening the senses. I experienced every incision with the added enhancement of THC. My wounds were on fire. I needed medication to dull the senses, not heighten them. I was in another prison of my own making, trapped in the chair, a patchwork rag doll, paralyzed by a thousand pins, wondering how I would make it through the night.

But there was the box—the one that held my terror. I risked releasing my demons if I opened it in a pot-addled stupor. But the alternative was too agonizing.

You’re going to be fine, I told myself. This too shall pass. Marijuana highs are temporary. Stuff the fear and self-loathing into the box, grit your teeth through the pain, and sit tight.

A few hours later, as my senses dulled back to normal levels, I slept, exhausted and defeated. Could I ever trust myself again?

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I’ve always been a doer. A compulsive crafter and cook. As the final season of Gilmore Girls came to a close, I propped a tray across my lap and spent hours cutting and gluing paper flowers. I practiced calligraphy and made notecards for the nurses who had shown me love and compassion in the darkest moments of my hospital recovery.

“We should eat family dinner together!” I announced to my husband and kids. But I was still too fragile to descend the stairs to our kitchen table. So my kids brought a picnic blanket upstairs and laid it on the floor by my feet. Each evening the three people I love most in this world sat cross-legged before me and dished out food dropped off by friends onto plates, ate, laughed (me, carefully so as not to rent open my stitches), and shared our day’s experiences.

As I steadily healed, I found a new show to binge—a documentary series about traditional Indian cuisine called Raja Rasoi Aur Anya Kahaniyan, which translates into Kings, Kitchens, and Other Stories. It triggered an intense desire for the nourishment I had been raised on in my Indian household. I hobbled downstairs, and slowly, painstakingly, stubbornly, cooked an elaborate meal of spiced lentils, vegetables, and rice.

The fragrance and tastes of clarified butter and tempered mustard seeds, of warm spices and steaming, simmering grains were an elixir. That evening my family and I shared the bounty. I had cooked the meal on my own, battered body and all, and finally acquired the control I had been seeking.

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George Michael, whose music formed the soundtrack to my teenage years died that Christmas. I mourned him and played Last Christmas on repeat, learning how to pluck the chords on my ukulele. Four days later, two of my drains came out at my post-surgery check-up. A few weeks later, the final two drains came out. The date of my revision surgery—outpatient, thankfully—was set. The swelling had receded and my reflection was more Rubenesque than surrealist.

On January 21, 2017, 40 days after my mastectomy, incisions still tender, I returned to work. My self-assigned task: To cover the Women’s March that mobilized three quarters of a million people onto the streets of Los Angeles in protest of the Trump presidency.

The train cars to downtown LA were jammed full of people sporting pink pussy hats and carrying signs about women’s bodily autonomy. In between interviews, I held my arms aloft, terrified someone would bump into me among the throngs of protest attendees and injure my still-healing body. My feet ached and my senses objected to the inordinate exertion. But I was jubilant. I was alive. I could breathe.

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I’ve always been a doer. I could have talked myself out of the surgical mutilation I endured, hedging my bets that the cancer would never come. And if it did, perhaps it wouldn’t be so bad.

But the nurse who comforted me in the hospital had been right. The worst was over and I had healed faster than I’d thought was possible. Six months after my surgery, I joined a local gym and began lifting weights. My new breasts were perky; twin terracotta nipples tattooed on by my surgeon were the final touch.

Today, the skin around my stomach incision is numb and always will be. My nipples will never again be the powerhouses of pleasure they once were, for they too are numb and will always be. The cut-and-paste seams remain stark, scars of the horror I put myself through. But they are also talismans against the terror of cancer, for I had cut my risk to nearly zero.

Sometimes, when my numb skin is dry I can feel an itch but it is tucked deep inside me where I can’t scratch. That’s when the regret returns.

All I can do is smack the skin to quell the insistent itch. The smacking can jolt open the box where I hide my terror. Dread seeps out into the places where I feel nothing and everything. And, bit by bit, the box empties.

Watch our interview with Sonali about her essay:

Sonali Kolhatkar is an award-winning multimedia journalist, and host and executive producer of the nationally syndicated television and radio show Rising Up With Sonali. She is the author of three nonfiction books including Rising Up: The Power of Narrative in Pursuing Racial Justice, and Talking About Abolition: A Police-Free World is Possible. She is a monthly columnist at the Independent Media Institute, OtherWords, and Truthout. Her debut novel, Queen of Aarohi, is forthcoming from Red Hen Press in 2027. She lives in Pasadena, California with her husband, two sons, her parents, and a spoiled cat.