Editor’s Note: Briana Arnold is a Hoquiam High School graduate who wrote a series of pieces for The Daily World on her experience as a Peace Corps volunteer in Panama. The pieces ran about two years ago. She returned from Central America last August and this is an update on her journey.

By Briana Arnold

Can you believe it was a year ago that I was saying goodbye to all of the people in a little village in Panama who made my two years there unforgettable? I sure can! A lot has happened since then.

Now, instead of jungle rain beating down on my thatch and tin roof, the tropical sun setting behind palm fronds and banana tree leaves every night, the rain of the Pacific Northwest hammers down on lush evergreens and the skyline of Portland zooms by on I-5. I now live just outside of Portland, in Oregon City – a big change from the tropics!

My job has also changed, taking on a different feel from working with indigenous cacao farmers; now I work for an organic and natural foods company called Pacific Natural Foods. We have several farm operations where I supervise a poultry operation, growing chickens, turkeys, and ducks for soups, broths, and other products as well as doing some research and development in our slower seasons.

Like a track on a song that habitually skips back, so does my mind to the development work I did in Panama, knowing that my life is destined to bring knowledge and empowerment to others, whether that be through volunteering or my professional career.

But I am happy with my current job for now, which encourages me to think and grow in a different way than Panama. And any drastic life changes will have to wait because I have much bigger fish to fry.

In the series that I started writing for The Daily World a couple of years ago about my experiences in Panama, I briefly mentioned a genetic risk that I carry that puts me at a higher risk for cancer. It is a risk that my own mother, Grays Harbor native Lisa Sund, also a previous Peace Corps volunteer in Paraguay, died from in her late 40s. That eventually led to my search for a genetic test to help me understand my own cancer risk, which has now taken center stage in my life.

When I was 21, I learned that I carry a genetic mutation called BRCA (BReast CAncer 1 or 2) that you may be familiar with from Angelina Jolie’s frank 2013 piece in the New York Times. In short, women who have the “1” version of the mutation are at an 87 percent lifetime risk for breast cancer and a 43 percent risk for ovarian cancer, among increased risk for other cancers.

The knowledge that I am BRCA1+ has influenced me, from my daily decisions like how to eat and exercise, to life changing decisions, like serving in the Peace Corps and loving deeply, as well as awareness of preventative measures.

So, recently, when my doctor found a localized thickening of breast tissue and recommended a preventative mastectomy, I scheduled immediately. This is a drastic but logical procedure that will decrease my risk for breast cancer by 95 percent, whereas the risk of getting breast cancer in the general population is 12 percent. The procedure is basically the removal of all the breast tissue from both breasts, although there is always a little bit left behind. Getting all of it out would be like picking all of the white-colored pieces of sand out of the multitude of colors of sand on the beach. Besides a healthy, preventative lifestyle, this is one of the best ways to decrease breast cancer risk.

While getting the breast tissue out is the most important part for my longevity, what does that mean for my appearance? Will I be like many women who have bravely chosen to go flat chested? Or get implants? Well, I will be neither. Luckily, I have options beyond both.

I am still young, single, and a bit vain about my body, not excited about the idea of being flat chested when breasts are one of our society’s main identifying factors for femininity. And, I have a gross aversion to implants, which typically only last 5 to 10 years, requiring replacements and many follow-up surgeries. In addition, implants are made with silicone (even saline implants have a silicone shell), which at one point were found to be carcinogenic and something that my mother abhorred about her implants. Did I mention that she had a prophylactic mastectomy in the 80s after her sister, then mother, died of breast cancer? The BRCA1 gene wasn’t even identified until 1994, her mastectomy contributing to her forward thinking braveness.

While the previous two options for many reasons are the right decision for many women, I’ve elected to undergo one of many types of flap reconstructions, which is taking a flap of tissue from one part of your body and using it to reconstruct breasts. The surgeons will take a flap of fat from my belly to build new breasts, a day-long surgery that requires great skill and experience reconnecting lots of little blood vessels so the fat lives and doesn’t turn into gelatinous goop, but when successful requires little follow up and for me is a long-term, sustainable choice.

Some women who no longer have breasts after a cancer diagnosis do not have the option for breast reconstruction because of damage to their skin from treatments like radiation, which can make the skin un-stretchable and inoperable to accommodate implants or other types of reconstruction, so I am lucky to have many options.

At 27 all of this could be overwhelming, but I am keeping myself busy with work and starting a project collecting international views on cancer that I hope to compile into a book. And when I think of all of the difficulties and trials that individuals and families have gone through fighting cancer, including my own family, I am thankful for what modern medicine, and the time to educate myself on this genetic mutation, has given me.

Those with questions regarding the topics Briana has discussed, may contact her at: arnold.briana02@gmail.com