‘When we ran your bloodwork, you tested positive for a harmful variant of the BRCA gene. Do you know what that is?’

I shake my head no, but Millie nods. She’s frowning.

‘The BRCA genes are inherited from your parents and produce proteins that help repair damaged DNA. But there are harmful variants of the genes. Millice—excuse me, Millie, you tested positive for a harmful variant of BRCA1, which increases the likelihood that you will develop breast cancer at some point in your life. While your scans are clean now, this is something you should be aware of. And—’ Dr Taylor looks meaningfully at me ‘—it’s genetic. So, you should probably get tested as well.’

I swallow. My throat feels dry.

‘Got it.’ Millie fidgets with her hands.

‘So . . . what’s next?’ I ask, filling the silence.

‘Well, you have a couple of options.’ Dr Taylor folds his hands in his lap and peers over his glasses. I focus on the wisps of white hair that are out of place instead of on his face, which I’m sure is about to deliver more bad news.

‘You can do nothing, which is not recommended given your family history and genetic makeup. Or, you can explore taking preventative measures, which is what I would recommend. You could be a good candidate for a double mastectomy.’

Millie doesn’t say anything, she just looks at Dr Taylor.

‘Double mastectomies are getting more and more common. We separate your breast tissue from your skin and muscle and remove it, which substantially lowers your risk of getting breast cancer. There are reconstructive options as well.’ He pauses, and his tone softens. ‘Look, I know this is a lot to think about. Why don’t I give you two a minute . . .’ he pauses, and pulls a pamphlet out of his front coat pocket ‘. . . and I’ll leave this here. It explains BRCA in more detail. I’ll come back shortly to answer any more questions you have.’

Millie nods.

‘And remember, this is good news,’ he emphasises on his way out the door.

‘Thank you, Doctor,’ I manage to choke out, but my voice sounds scratchy and foreign. The room falls into silence apart from the gentle ticking of the clock on the opposite wall.

Millie collects herself quickly, taking a few deep breaths before she starts explaining to me how much research she’s already done. It only takes her a few moments to decide. She’s going to get the double mastectomy. She doesn’t want this hanging over her head. If insurance will cover it, she’ll do double mastectomy and reconstruction at the same time.

She’s speaking with such force and surety that I can tell she’s been thinking about it for days, anticipating this as one of the outcomes of her biopsy. She’s thought through all her options and charted the best path forward. I’ve always been impressed by her decisiveness.