Run the risk of dying an early death from cancer or take the drastic step of having both breasts surgically removed.
That has been the dilemma facing 26-year-old Birstall woman Emily Ranoble for nearly a decade, having lost all but two women on the maternal side of her family to the illness over two generations.
She has grown up surrounded by breast cancer. Her mother, Shelley, was first diagnosed when Cambridge-born Emily was just seven and passed away two years later.
Her grandmother fought the condition when she was in her 30s, as did her auntie.
The only two women in the family to survive had drastic double mastectomy surgery to remove both breasts.
Spurred on by her family history, care home manager Emily has decided to take her future into her own hands.
She will go under the knife for the operation and reconstructive surgery at Pinderfields Hospital on April 13 – her second wedding anniversary.
“It’s either have a mastectomy or die from cancer,” she said. “It will be quite unpleasant but it’s a minor disruption to my life compared to what developing cancer would be.
“It’s definitely the lesser of two evils.”
Living with the shadow of the illness looming large, Emily decided to leave any thoughts of assessing her chances of developing cancer until she was 25 given that the common age among her family for diagnosis was around 30.
In 2013, as her 25th birthday approached, she finally began to take steps to look at her options.
Emily was tested for a BRCA gene mutation, which puts women at much higher risk of developing the disease.
She tested negative, although doctors labelled her as high risk. About five per cent of breast cancers are thought to be hereditary.
She said: “Being given my operation date was a bit of a shock. I thought I would get more notice.
“It’s a really good day for me. It’s got good memories and good things have happened to me on April 13. I’m taking it as a positive omen but I’m definitely thinking about it more – now it’s real.”
Doctors expect Emily to leave hospital within a week, although her recovery is likely to take around a month.
As part of her journey back to full health she hopes to take part in a Cancer Research UK Race for Life run this summer
• Read the first of Emily’s weekly columns on our website tomorrow.