A more thoughtful response might be to encourage her to look deep inside herself, and way, WAY down the road. Is she so fearful of what reconstructed breasts would mean to her love life that she’ll risk almost certain cancer to keep her real ones? Is her desire to have children so potent that she’s willing to take a 50-50 chance on ovarian cancer, and probable death?

Or can she figure out a way to walk some scary tightropes? Having a double mastectomy and reconstruction with the belief that she’ll still be a desirable woman, still be able to date comfortably. Becoming a single mother now, thus having her ovaries out more quickly; or waiting, hoping to become involved in a relationship that results in children before she’s 40. And, to me, the most gut-wrenching decision of all: knowing that she can identify unborn children who carry her BRCA gene, and deciding what to do with that knowledge.

At the end of the day, these decisions are like so many cancer decisions we’ve all had to make. You just simply… decide. One way or the other. Then live with your decision. You have no choice but to move forward, so you do.

But Queller’s situation, and that of all BRCA carriers, is more extreme than what most of us have faced. These women are not only trying to control their own destiny, their own life and death; they also have the ability to “play God” with potential children.

Making decisions with this level of consequence must be insanely stressful. Are you a BRCA gene carrier? Tell us your story: the decisions you had to make, how you made them, and how you handled the process.

Update: In the end, Jessica Queller decided to have a baby via anonymous sperm donor. In an NPR interview aired June 23, 2009, she said she was currently 4 months pregnant, and had just found out the child is a girl.

When asked about her daughter's chances of carrying the BRCA gene, Queller said she'd discussed the situation extensively with her oncologist. "She told me that the medical landscape will be very different in 30 years," said Queller, referring to the timeframe when her daughter might begin to worry about breast and ovarian cancer. "I'll urge her to be tested [for the gene], but not before she's 20 or 25," added Queller.