I will never forget when my doctor told me, "There's a lump in your breast that we need to check further." I was in her office for an annual exam. As a woman in my late 20s, I did not expect to hear these words. The room started spinning. My breath grew shallow. I must have looked panicked because she asked me if I needed some water. "Yes!" I exclaimed.
I was terrified because I am an Ashkenazi woman with a family history of breast cancer. I know that women like me tend to be at higher risk for developing certain cancers due to our increased risk of carrying mutated BRCA genes. Although BRCA genes are normal and everyone has them, individuals who have inherited a mutation in BRCA1 or BRCA2 have a significantly heightened risk of developing certain cancers. One in 40 Ashkenazi Jews carries a BRCA gene mutation, a statistic 10 times higher than that of the general population. That being said, BRCA gene mutations affect people from a wide range of backgrounds. Regardless of gender, people with this mutation have an 85% lifetime risk for breast cancer; they also have a higher risk of pancreatic cancer and melanoma than the general population. Those who were assigned female at birth have a 50% lifetime risk for ovarian cancer and those who were assigned male at birth are more likely to develop prostate cancer.
These statistics, combined with Jewish wisdom, teach us that cancer education and testing is a Jewish issue. According to the principle of, Judaism regards life as something we are obliged to protect. Leviticus 18:5 tells us, "You shall keep My laws and My rules, by the pursuit of which human beings shall live." Similarly, Deuteronomy 4:9 tells us, "Take utmost care and watch yourselves scrupulously." The concept of pikuach nefesh appears in the Torah, rabbinic literature, and codes of Jewish law. For example, we read this midrash in Leviticus Rabbah 34:3:
"Once when Hillel was leaving his disciples, they said to him: 'Master, where are you going?' He replied: 'To do a pious deed.' They asked: 'What may that be?' He replied: 'To take a bath.' They asked: 'Is that a pious deed?' He replied: 'Yes. If in the theaters and circuses, the likeness of the king must be kept clean how much more so is it a duty of human beings to care for the body, since human beings have been created in the divine image and likeness?'"
To care for our bodies so that they remain healthy is a holy act. It is a way of protecting humanity, a holy creation of God. This includes testing for BRCA gene mutations and scheduling screenings as early and often as possible. I know that these tests can be frightening, costly, and uncomfortable. Remember: testing positive for a BRCA mutation does not necessarily mean a person is going to develop cancer! Instead, this knowledge provides power. With this knowledge, a person can make intentional choices about how to best protect their health going forward through specialized screenings, risk-reducing surgeries, or targeted medications.
I scheduled an ultrasound two weeks after my exam. In the interim, I talked to my parents and learned they are not BRCA mutation carriers. Although the ultrasound did confirm the lump, a further biopsy let me know that it was not cancer. When I found that out, I took a deep exhale for the first time in two weeks.
I felt grateful and renewed my commitment to educate myself on breast health and talk to my doctor about preventative measures. Because of my Ashkenazi ancestry and family history, my doctor has taught me to conduct breast self-exams, notice the signs and symptoms of cancer, and suggested that I start annual mammograms earlier than most. I am grateful I have the chance to protect myself in these ways.
October is breast cancer awareness month. Take this as an opportunity to bring holiness into your own life through. Look at your breasts. Has their appearance changed? How do they feel? Schedule an exam if you are overdue. If possible, talk to family members about whether there is a history of cancer on either side. Schedule a BRCA test if you have not already been tested. Our tradition demands that we protect ourselves. Making intentional choices now could mean the difference between life and death later.