Today's my birthday and I received lots of well wishes and some great gifts. Much better than twenty years ago on my birthday when I recieved a devastating diagnosis.

I was told I had breast cancer. Then I was told I didn't. Then I was told again that I had it. And then I was told I sort of had it. "Benign with atypia" was the final word.

After my mother died from this horrible disease and my older sister was going through the rigors of chemo I figured it was just a matter of time. Then even before exploring my options and there weren't many, remember this is 20 years in the past, I had a thought. I remembered how one of the Kennedy kids had cancer in his leg and it was cured by amputation. I wondered why not get rid of the body part that causes the problem? At that point the concept of a preventive mastectomy was considered pretty radical, forgive the ghoulish pun.

I didn't anguish. If anything I felt fortunate that it was a body part you could easily spare. What was upsetting? Sitting in the waiting room at the radiologist watching your young children in the play area and then being called back in for a "better look" is upsetting. By the ninth one, you know it's not good.

During the biopsy on my 37th birthday the surgeon was confused as to which side it was before he operated. They had reversed the directions for my operation. I pointed to exactly where he would find the tumor. I had mentioned a pain in that spot to my ob-gyn a few years back and he had dimissed me, saying I was just imagining things because my mother had died.

The surgeon laughed and told me I was going to be fine. I struggled to stay conscious as he cut to hear what he saw. He told me I should have a party as it didn't look malignant, I was going to be fine, and then I woke up and the first thing he said to me was "It was cancer", no how do you feel, just a bit about how I'd probably live to 60 and die of something else. For ten days I wandered like a zombie around my home trying not to break down in front of the my children, who knew something was up nonetheless.

You see when they tell you your survival rate it's all based on 5 years. My daughter was 5. My son was 2.

I waited to hear when they could schedule my treatment. Remember this was 20 years ago. And then the surgoen called. He told me as a precaution they always send a slide to Mayo on that 5% chance their visual diagnosis is wrong. And sure enough. Once again he told me I should throw a party because I only had pre-cancer.

After that the decision to have a preventive mastectomy was a no-brainer. I had the blessing of my oncologist. And that surgeon, well he had the luck that we had moved overseas right after the biopsy and I was too preoccupied to sue him for extremely bad bedside manner. I returned to the states for the summer and asked for the operation.

The male surgeon kept asking me if I was sure. He thought I was overreacting. I thought it was the most sensible thing in the world. The insurance company didn't want to pay. But I happen to be able to write a very presuasive letter. They paid.

I remember coming out of the fog after my operation. A woman in scrubs I hadn't seen before asked me how I was doing. I told her I was ok and just anxious to go home without the black cloud of cancer hanging over my head. She told me she had been on my surgical team and she thought I was very brave.

So when actress Angelina Jolie announced she had had it done, I got it. She lost her mother to cancer. She has the gene. She has 6 little kids. Simple decision. But when you make your living by being beautiful it probably took a lot more guts.

And just when the dust had settled, breast cancer survivor and popular singer Melissa Ethridge decided to weigh in and stated Jolie's decision was based on fear. She backtracked somewhat but talked about "acidity" in her life causing the cancer. Of course nutrition and stress can play a part in cancer but there are also a hundred other reasons and probably a thousand other gene mutations over which you have no control. I get really pissed when someone blames the cancer patient for their disease.

Was Angelina's decision heroic? Yeah I think so. Is it right for everyone? Only they can know. Is it based on fear? I think it's based on responsibility to your family. Losing my mom when I was 30 was so painful, losing my sister later was heartbreaking. Call it fear, call it whatever you want. No way were my kids going motherless, not on my watch.

And this idea of bravery. I think it's the survivors out there facing every day with courage who can claim that.