Nele Reymen: "Happy with my new breasts"

If you are a carrier of an inherited breast cancer gene, you are at much higher risk of developing breast cancer during your lifetime. Therefore, you must make difficult choices. Do you go for the intensive screening program with a six-monthly mammogram and ultrasound, starting at age 35, or do you opt for the preventive removal of both still healthy breasts, so that your risk of breast cancer drops to virtually zero? Nele Reymen chose the second solutions went for a double-sided mastectomy with immediate reconstruction at age 40. "I already knew around age 30 that I was a carrier of a hereditary breast cancer gene, so my risk of breast cancer was around 40 - 45%. Just like both my sisters, by the way. Our mom developed breast cancer at a young age and turned out to be a carrier of CHEK2." CHEK2 is a lesser known breast cancer gene, immediately slightly lower risk of breast cancer than carriers of a BRCA gene, but still very high. High enough to face the same choice: follow up or have it removed preventively.

Responsibility

The moment the verdict fell and Nele knew she was a carrier, she was not mentally ready to think about that difficult choice. "I am the youngest of three sisters. My sisters already had children at the time we heard the results of the genetic test, and both chose bilateral amputation. I myself did not have children and was not mentally ready for that. I didn't want to deal with that at that time. Once I also had two children, the question arose again, but I hesitated again. You fall out for a time because of the surgery, when you want to take care of two little kids. On the other hand, when you get breast cancer, you also fall out and for a longer period of time ... A strong sense of responsibility to my children finally helped me to tie the knot. I know I can get breast cancer, I have to prevent that, I have to prevent that." Once she decided, things moved pretty quickly. Last fall, in November 2023, Nele went under the knife.

Nele received an amputation and deep flap reconstruction (with tissue from the abdomen) in one operation. "My doctor warned me beforehand that the mental impact of the surgery was great. But I only understood afterwards what she meant. I felt like my wings had been clipped! After eight weeks, I felt a lot better, but I'm not there yet," she says. The pain is treatable, but the long recovery time creeps into your clothes. In Nele's case, the surgery took nine hours, which is not at all unusual for this complex procedure. It doesn't stop there. Nele soon faces two additional procedures; a lipofilling of the breasts and a nipple reconstruction. "From all those you have to recover again. So I'll be busy for a while!"

Yet Nele does not lose her smile at it. She is clearly positive about life. "I am not a cancer patient, which makes a huge difference. I chose this procedure myself and I am happy with the result. The scar on the abdomen does fade over time. My new breasts are smaller, which I don't mind at all." Nele Reymen is well aware that her story does not apply to everyone. "I didn't lose my mom, my sisters are still around, and I'm not sick," she says, "I can imagine that as a breast cancer patient, you look at your treatment process very differently or painful memories surface when you've lost someone close to you."