Is My Life at Risk Because I Didn’t Have Children?

How do you move past the terror of being diagnosed as “high risk” for breast cancer?

“You are at high risk for breast cancer.”

The tech chooses to tell me this just after she has instructed me to hold my breath as she starts the scan. I already know this, and I already know the reason she is going to give me, but still, the statement knocks the wind out of me. I am suddenly filled with terror.

But I can’t breathe. If I breathe, the image won’t be clear. I’m trying so hard to hold my breath just a little bit longer, but I’m panicking and the pain of having my DD breast flattened like a pancake between the mammogram machine’s plates is beginning to overwhelm my nervous system.

I can’t help it: I take a breath.

She says, “Okay, you can breathe now.”

Oops.

“You don’t have children and anyone who hasn’t had children is at a higher risk. You also started your period fairly young, so we’re putting you in the highest risk category.”

I take a defeated step back, my breast pulling off the plate and making a ridiculous slapping sound as it falls against my chest. I feel sick. I feel scared. I was already scared when I came in for this diagnostic mammogram and the ultrasound to follow. Something is already wrong with my breast.

Now I have to hear again that my life might end prematurely — or that my body might have to be mutilated — just because I didn’t have children. Like I need more grief around that set of circumstances. I already feel enough pain about it.

The tech is a nice woman. She means well. I can see she’s trying to be calm and pragmatic.

She has no idea what it’s like to be 45 and realize that you will never become a mother. She doesn’t understand the grief that comes with that. My medical record shows that I have never been married and have no fertility issues, so maybe she assumes I chose this. That I don’t like and didn’t want kids.

If there’s one thing I know, it’s that single women tend to be put into easily labeled boxes. People don’t see nuance here. They don’t understand that our lives and circumstances are as complex as women who got married and/or had children.

There are a million tiny details important to my story, but I know she doesn’t see any of them.

I feel strangely reduced. Like a pot of water that’s been boiling for so long that most of it has evaporated.

And with her words ringing in my head, all I can think of is…death.

I recently talked to my financial advisor during our yearly check-in. Though we’ve never talked about what to do with my modest savings in the event of my untimely death, she brought it up this time. Maybe there’s some kind of timeline that says 45 is the year to work out all those bequeathments.

I can’t say I was surprised or upset by the question. My mortality has been on my mind, of late.

Earlier this year, I updated my will for the first time in over a decade. And last year, I went through all the boxes filled with items from my childhood that I had been saving to pass down to my own daughter, and I gave them to my nieces.

That last one was actually pretty hard for me. There were a lot of tears as I pulled those items out of the boxes and came to grips with the fact that there would be no daughter to receive them. A lot of tears as my nieces carried them away, the ghost of the one daughter I almost had a wisp in the ether around us.

But it also felt right. Babies die. Dreams die. And I will die, someday, too. I can grieve the losses I’ve had, but still make sure to leave a legacy for the children in my life that I love — even if they are not my own.

So I was more than ready to tackle this subject.

We talked it over — I currently have 8 nieces and nephews to whom I would wish to leave this money, and all are minors. So we’ve worked out a plan in which I leave a certain percentage to each sibling to distribute to their children when they are 18.

I suppose it’s fair to say I feel some comfort in all this. I like feeling prepared — even when it comes to my own death.

Though it also reminds me how much death has been on my mind these past three years, when my breast symptoms began. It happened right after I bought my first house, all on my own. As powerful as that felt, I remember being awash in fear. Was this it for me? Was I going to be single and childless for the rest of my life? Was the solo purchase of my house a harbinger of what was to come?

And then came the symptoms.

I can’t help but wonder if I bought into the cultural notion that, at some point, an unmarried and childless woman reaches an expiration date which roughly corresponds with the end of her fertile years. It seems awfully suspicious, given how terrified I was that this house somehow foretold that I’d be single for the rest of my life. And also given that I started experiencing the symptoms of perimenopause around that time.

Did I buy into the idea that I had no purpose left in society? That I’d reached the end point without achieving what I was supposed to achieve and therefore, it was time to just…die?

During the second mammogram scan, the tech asks if she can sign me up for the local high risk breast cancer clinic.

“You’ll answer all kinds of questions, get genetic counseling, and you can decide if you want to get a preventative double mastectomy. It’s a really great opportunity,” she says, sunnily.

Once again, my breast is being crushed to the point of pain and I’m holding my breath and trying not to panic. Between the constriction of the scan and the way she so casually talked about cutting my body parts off, I feel a true panic attack coming on.

“Do you want to do that?” she asks, as the scan completes and the plate on top of my breast lifts.

“Sure,” I wheeze, thinking that was the best way to get her to shut up.

Sure enough, she smiles approvingly, and says, “The best thing you can do in your situation is get more information.”

I’m not actually sure I want more information. After all, in the past three years, four doctors and numerous scans still have not identified what is wrong with my breast now. I’m not quite as concerned with the future.

Then I’m ushered toward the ultrasound room with an even more chipper technician, who makes me feel safe and comfortable immediately, until we enter the dark room. It’s covered with pictures of babies and a big sign outlining their policy for taking photos and videos during a prenatal ultrasound.

I feel empty, suddenly. Like a walking shell. I will never experience that. I will never get to hear my baby’s heartbeat or see their little fetal outlines inside my uterus. I will never feel that wand move its way across my abdomen as a joyful husband holds my hand and beams.

The time for that — at least for me — has passed. Or more accurately…it never came and now it’s too late.

During the ultrasound, I try to keep my eyes on the screen and away from the pictures of babies. That’s when I notice all the black blobs on the image. The tech says nothing for a long time as she takes still shots of each one, highlighting them with the cursor.

I guess this is it, I think. I really did run out of time.

But then she speaks. “These are cysts, just in case you’re wondering. I’m only documenting them because it helps us to know how your body works and whether or not your breasts have lots of cysts. It looks like yours do, which is good information to have — it means these are not something of concern.”

When she finishes, she asks me to wait there. Not to get dressed in case she has to capture clearer images — just to wait. So I sit there on the chair, staring straight at their policy on photographing and videoing prenatal ultrasounds. I only read the first few lines, then let my eyes blur the words.

There’s no husband here to hold my hand through this ultrasound. And no husband waiting for me at home to hear the results.

I don’t mind that — I have friends who are waiting to hear from me, friends who love me deeply. But I feel the sting that always comes when I remember yet again that I will never be a young wife and mother. That dream died a long time ago.

Suddenly, the tech breezes back in. “You’re good to go!” she declares. “There is nothing worrisome on any of your scans. You’re clean.”

I feel overcome with relief…except that my breast still hurts and I still don’t have answers. What on earth am I going to do now?

“I saw you signed up for the high risk clinic,” she continues. “I’m so glad to hear that. You definitely need to do that with your risk level.”

My relief starts to wane.

I understand how this works — why they believe childless women are at high risk for breast cancer — but I find it so hard to believe that even one pregnancy can make that much of a difference. I’m not poo-pooing the research and statistics, but also, something about it all too conveniently fits into the narrative about what a woman is supposed to do with her life.

And yes, I wanted that, too, but it didn’t happen. Why does this feel like a horrible and unfair punishment for something that already felt horrible and unfair to begin with?

The tech leaves me to dress and see myself out. Last time I was here, the building was bustling with people and conversations. Now, in COVID-era, it’s deathly quiet and there isn’t a soul to be seen in this dark hallway.

I finally find my way to the main desk and ask the man sitting there if I need to check out. He leans back in his chair and smiles beneath his mask. “What you need to do is go have a beautiful afternoon.”

I smile. Then laugh a little. Yeah. That’s exactly right.

I thank him and step out into the blazing desert sunlight. I’m not going to die, it turns out. At least not today.

I’m filled with joy. And also an overwhelming sense of grief and fear.

What now?

© Yael Wolfe 2021