To Tresia Metz, her cyst-laden breasts were ticking time bombs just waiting to explode with cancer. For years, her mammograms generated the dreaded follow-up phone call informing her more tests were needed. When she received the follow-up call to come in for an ultrasound in April, she had had enough. “I told (my husband Jim) ‘I can’t take it anymore, I want these things off me,’” Tresia said. She underwent a prophylactic mastectomy in August.

To Tresia Metz, her cyst-laden breasts were ticking time bombs just waiting to explode with cancer.

For years, her mammograms generated the dreaded follow-up phone call informing her more tests were needed. When she received the follow-up call to come in for an ultrasound in April, she had had enough.

“I told (my husband Jim) ‘I can’t take it anymore, I want these things off me,’” Tresia said.

Test Anxiety

Tresia, of Freeport, underwent mammograms every six months and an MRI once a year. And every time, there were more lumps and more biopsies.

“I remember laying there and two doctors came in looking totally stunned. One of them said, ‘You have the worst ultrasounds we have ever seen. You have two large cysts at 1 o’clock, you have one at 5 o’clock, two smaller ones at 6 o’clock, you have two larger ones at 9 o’clock’ - and this was just on my right breast.”

The agony of waiting for test results was a heavy burden, especially with two young children at home. The couple’s children include Christopher, 8; Carolyn, 6; John, 24; and Celeste, 23.

“Every six months I thought I was going to have a nervous breakdown just waiting and waiting,” Tresia said. “It went on for a few years and it was just awful trying to act like everything’s ok with the kids – the older ones understood.”

On the day she was set to do her follow-up test this year, Tresia called her insurance company and asked if a prophylactic mastectomy would be covered. They told her they do cover the procedure, but she has to answer yes to at least one of five questions to qualify.

“Has anyone in your family ever been diagnosed with breast cancer under the age of 50?” her caseworker asked.

“And I said my sister was dead when she was 30 from breast cancer, and my mother had breast cancer when the first time she was 49.

“She said, ‘You qualify.’ ”

Family Influence

“I started thinking about this when my mother and my sister both had cancer,” she said.

Her mother was diagnosed in 1999 the first time and died of a different type of cancer last year. Her sister, Tara (Mills) Garza was diagnosed at age 27, and died in 2003.

“She had contacted her doctor about having a lump and he told her she was too young. She was dead in two years,” Tresia said.

Tresia’s aunt, her mother’s sister, died of breast cancer three days after Tara died.

“In the back of my mind, I was scared to death, especially after Tara had died,” she said. “I kept thinking I don’t want these things, these things are going to kill me.”

Tresia had been an LPN, and she would encourage women to get mammograms when they reached 40 years old. At 34, Tresia kept thinking she still had six more years to go until she could have her first mammogram. She waited close to a year, then called her insurance company and told them of the breast cancer history in her family.

"I told them my sister’s dead, my mother’s dead, my aunt’s dead, and I don’t want to die," Tresia recalled.

Proactive Stance

Tresia was referred to the University of Wisconsin Hospital in Madison, where she was tested for the breast cancer genes.

“It turned out that I was not carrying either one of the genes; however, they believe there are more genes that they just have not found yet,” she said.

Jim said the doctor told Tresia even without carrying the gene, her chance of developing breast cancer was 40 percent.

Despite not carrying the gene, Tresia’s decision for a mastectomy was not quelled. Her insurance company, an HMO, recommended Lynn Sage Breast Center in Chicago, where she was seen by Dr. Seema Khan.

The doctor explained all her non-surgical options, including continuing her annual mammograms and taking the drug Tamoxifen.

“So I’d have to take that pill for the rest of my life and still go every six months and have the mammograms and MRIs.”

This course of treatment would reduce her risk to approximately 30 percent.

“She just put all the options out there,” Tresia said.” I already had my mind made up before I got there, I knew what I wanted to do.”

But the doctor asked her to think it over, and would not let her make an immediate decision.

The Surgery

On Aug. 4, Tresia underwent a bilateral nipple sparing mastectomy. The breast tissue is removed, but the skin remains and is pulled over the implants and stitched into place.

“Most often the nipple can still be left on,” she said. “It’s a very, very thin piece of skin left.”

The surgery lasted six hours. First the doctor removes the breast tissue, then a plastic surgeon completes the implant process. Less than 24 hours later, Tresia was on her way home with drainage tubes and a morphine pump. Those were removed a week later.

The only complications from surgery was a risk she was warned of – numbness in an arm.

“They told me they could hit a nerve and you could have numbness in your arms – and they did,” she said.

Her left arm is fine, but her right arm is numb in the armpit area.

“It feels like rubber,” she said.

Tresia relied on Jim to drive to and from her appointments, and he took time off of work to help around the house and chauffeur their kids where they needed to go. Help from her assistants made it possible to keep her home day care business, Little Explorers Day Care, up and running the entire time.

One notable side effect for women who have this surgery is that their chest will be numb.

“You have no feeling in your chest,” she said. “You are numb. It’s permanent – there’s no feeling and women should know and understand that.”

She has had follow-up care with the plastic surgeon, to make sure blood flow is properly working and the incisions are healing. She has one final surgery scheduled with the plastic surgeon, then the process is complete.

Afterwards

“I feel like this tremendous weight has been lifted off my shoulders,” she said.

Rather than mammograms, Tresia will have an annual MRI, but without so much worry as before.

“The doctor said my chances, because of the surgery, have gone from 40 percent, to 0 to 4 percent, and most likely it’s 0,” she said.

There is a small chance some cancer cells could be in the nipple, she said.

For women considering the option of prophylactic mastectomy, Tresia encourages them to follow their hearts and talk to their families.

“Find out what all your options are and very seriously think about it,” she said. “You have to talk to your family, but also do what’s best for you, what’s in your heart. If you honestly think you can’t handle going year to year trying to figure out it they’re going to find another lump, then do it. I know it was very drastic what I did and I had a few people tell me that they thought it was very stupid of me to do it.”

But to Tresia, it was the best decision for her.

“If somebody has a strong history, they should start from the very beginning and get the gene test,” she said.

Freeport Journal-Standard