Healthy Woman Shares Why She Had Double Mastectomy at 21

At 21 years old, Lily Chugg was faced with a choice: undergo a double mastectomy to prevent breast cancer that had yet to manifest itself or keep her breasts and get screened regularly.

In the summer of 2022, Chugg, a content creator who lives in Australia, was found to be carrying the BReast CAncer gene 1 (BRCA1) mutation. The gene—and BRCA2 as well—which everyone has, generally produces proteins that help repair damaged DNA. But harmful variants, or mutations, increase the risks of several cancers—most notably breast and ovarian cancer.

"The gene runs through my family but we truly believed I wouldn't have it even though my sister Taylor, 24, and mom Nicole, 46, did," she told Newsweek. "We thought I wouldn't because I am so much more like my dad but it turns out the odds don't add up like that at all."

In January, Chugg would undergo a double mastectomy and reconstruction.

Chugg, from Port Stephens, in southeastern Australia, recently shared her story on TikTok (@lillychuggg), which was viewed more than 304,000 times. According to the specialized medical service, Sydney Cancer Genetics, it is estimated that in Australia one in 500 people carry a BRCA1 mutation and one in 225 people carry a BRCA2 mutation.

Chugg was tested for the gene in August 2022. She was not prepared for the positive test result she received eight weeks later.

"I will admit I was oblivious prior to receiving the results, so it was a total shock," she told Newsweek. "The strangest feeling overcame me when we got the news. I didn't prepare myself at all. It was a lot to deal with. It was hard at first but I knew I was going to have the surgery as it was an opportunity to eliminate cancer at a young age."

Chugg said it was "easier" for her to come to terms with the surgery as her mom and sister had been through it too. But she understood not everyone has support in their inner circle, which is why she shared her story with her 128,400 followers.

"If I didn't have Taylor and my mom, it would be a whole different journey. I am happy to have my platform and my messages are always open for girls who have questions," she said.

A bilateral prophylactic mastectomy may reduce the breast cancer risk by about 90 per cent in mutation carriers, according to a 2018 European Journal Of Breast Health study.

Chugg explained that the medics were reluctant to carry out the procedure because of her age. However, she was keen to minimize the risk because a cousin passed away when she was 35 after being diagnosed with breast cancer.

Chugg's mother, Nicole, told Newsweek: "We have a strong history of breast and ovarian cancer in our family. As soon as I found out, I booked in to get a mastectomy as I watched my cousin lose her battle with cancer despite going through chemotherapy and having one breast removed. I knew I wanted to be there for my children."

Since posting the viral clip on August 15, Chugg has received messages daily from other women in the same position as she was. She told Newsweek a common theme seems to be a lack of urgency from medics to go ahead from the operation.

Dr. Alberto Montero is the clinical director of the Breast Cancer Medical Oncology Program at University Hospitals Seidman Cancer Center in Cleveland, Ohio.

He told Newsweek: "This is not a matter of physicians believing or not believing in the value of surgery. Again, in a woman who doesn't have breast cancer but is a BRCA carrier, typically physicians would counsel to hold off on surgery and to do screening with breast MRIs and close follow-up.

"There is no urgency once you are diagnosed as a BRCA carrier to have preventative breast surgery or a hysterectomy. Such preventative surgeries are scheduled typically to coincide for just before reaching the age when the probability of breast cancer starts going up. Breast MRIs are very good in picking up occult breast cancers and in women with a history of breast cancer who are BRCA carriers and who don't want to undergo a bilateral mastectomy right away."

Montero, who is also an associate professor of medicine at Case Western Reserve University,explained the benefits of any surgery has to be balanced against the risks.

"If a patient has a diagnosis of breast cancer, a timely surgery is essential for good outcomes. However, in the case of someone with a BRCA mutation and no evidence of breast cancer, timing for the surgery does not improve outcomes. In other words, for a preventative surgery there is no need to proceed so urgently for surgery particularly in someone so young. The incidence of breast cancer even in someone with BRCA mutation doesn't start going up until a bit later than the age of this patient," he explained.

So far, the four-minute long video posted by Chugg has racked up 10,400 likes and many comments.

"Thank you for sharing and spreading awareness! This is something I wouldn't have previously considered," praised one user.

"This video came at such a good time. It's nearly been three months since waiting for my results! Hopefully soon. Thanks for spreading awareness," said another.

Update 9/19/23, 2:08 a.m. ET: This article has been updated to add Dr. Montero's workplace.

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