I Stayed in Control of My Breast Cancer Treatment by Rolling With the Punches

For Twilah Richardson, 51, there was never any question that she would take the lead on her breast cancer treatment all the way through. "I can't imagine how one could survive this experience intact without taking control to the fullest extent possible," she says. As it turned out, however, being in charge sometimes meant learning to give in to the unpredictability of the disease.

Plan one: chemo plus lumpectomy
When Richardson's first surgeon recommended a double mastectomy after her 2007 diagnosis of invasive ductal carcinoma, she balked. "I wasn't prepared mentally to deal with a bilateral mastectomy," recalls Richardson, then 50.

She went for her breast surgeon's suggestion instead—to try to shrink the tumor with chemotherapy to make it small enough for a lumpectomy. "Because of the size of the tumor relative to my total breast mass, it would have been very disfiguring to take the whole tumor out [and not remove the breast too]. So when he mentioned the neoadjuvant option to me, I jumped all over that."

But things didn't go quite as planned for Richardson, who lives in Allentown, Pa.: The chemo failed to shrink the tumor. "Every two weeks I did the [Adriamycin and Cytoxan], and then following the fourth treatment, I went to see the breast surgeon again, and it hadn't had a noticeable effect on the tumor," she says. "The diameter was pretty much the same."

Plan two: double mastectomy
Richardson ended up having to have both breasts removed after all in June 2007. "I didn't want it to come back in the other breast, and I knew the cosmetic results [with reconstruction] would be better. My doctor said he totally agreed with me. His reasons were clinical and mine were emotional, but there wasn't a whole lot of emotion at the time—I felt cold and calculating about it, frankly."