Dilemma: Joanne Payne with mother Carol, who believes breast cancer is genetic When Carol Payne, 48, was diagnosed with breast cancer the news was devastating. But for her daughters Francesca, 28, and Joanne, 15, the ramifications were terrifying. For while Carol, who is divorced, refused to have a mastectomy because she felt it would ruin her femininity, schoolgirl Joanne wants to undergo radical preventative surgery. If she goes ahead she will be the youngest woman in the UK ever to take such a drastic step. Carol is horrified, but Joanne believes it could save her life. Carol from Eynsford, Kent, says: Like any teenage girl, Joanne loves shopping and clothes. But at the moment it brings tears to my eyes seeing her look so beautiful in the fashionable outfits she so enjoys wearing. In a bid to avoid contracting the breast cancer that has stalked three generations of our family, at the tender age of only 15 Joanne has chosen to have a double mastectomy, a potentially disfiguring operation which I cannot bear the thought of her having. To me, she is still a child. It has been a devastating year. Last June, I was diagnosed with an aggressive type of breast cancer. It was obviously terrible for me, but telling my two daughters the news was even worse because I knew that my diagnosis would have heart-wrenching and far-reaching consequences for them, too. My sister, mother and grandmother have all battled the disease since it is genetic in our family, so my daughters are also at high risk of developing breast cancer at some time in their lives. My eldest daughter, Francesca, coped by not talking about it. At 28 she feels it is something to be dealt with in the future. So, because Joanne is even younger, I expected her to feel the same way. But then two months ago she made the shocking announcement that she has decided to have her breasts removed and wants it done as soon as possible. It caught me totally unawares. Because she is so young and breast cancer is unlikely to affect her for years, it was the last thing I expected her to say. Ironically, a mastectomy was also the very operation I myself had recently turned down a day before I was due to go under the knife. As soon as I was told I had breast cancer, the consultant booked me in for a double mastectomy five days later, which he strongly recommended. But just beforehand, I decided I simply couldn't go through with it and cancelled the surgery. I just felt losing my breasts would make me feel less of a woman. Now, I have to face the fact that my beautiful daughter is actually asking to be put through that harrowing process. Perhaps she's decided that, seeing other people in the family fight breast cancer, she just does not want to take that risk. Our family nightmare began ten years ago when my mother, Sylvia, then 58, was diagnosed with breast cancer. She underwent a successful lumpectomy and radiotherapy and appeared to recover completely. Five years later, in 2001, my grandmother was diagnosed and finally a year later it struck my sister, Tracey. That was particularly shocking as she was only 37. Seeing my sister go through a lumpectomy, chemotherapy and radiotherapy was heartbreaking. It had also spread to her lymph glands, which meant it had a greater chance of recurring. When I went back to see my GP, she was frank. "Everything points to this being a hereditary breast cancer," she said. She explained we carried one of two breast cancer genes, probably BRAC1 or BRAC2, although there are others. I felt sick at the implications. Not only was I suddenly catapulted into high risk territory, it had terrible implications for Francesca and Joanne because I feared I could have passed on the gene to them, and, as they grew older, they too may have to face breast cancer. It was a devastating blow, and something a parent never wants to contemplate. The dangers they both faced were brought home to me in the most terrible way, when I too was diagnosed last year. I nearly collapsed when the consultant told me I had cancer. His verdict was that I needed a radical double mastectomy straightaway. He said the cancer in my left breast was aggressive and I should have a double mastectomy as it would eventually spread to my other breast. I broke down in tears, sick to my stomach with fright. The first thought was the girls and how they'd manage with me ill, or if I died, especially with Joanne being so young. Telling my daughters I had cancer was simply dreadful. I could see their worst fears had been confirmed. They barely said a word, they were as stunned as I was, because, despite the family history, the reality was still such a shock. However, the more I thought about the mastectomy, the more uneasy I felt about going through with it. I had looked at my body and realised I didn't want such a major op. The thought of having my breasts cut off felt like a medieval mutilation. I felt strongly that I would lose all my femininity. Losing my breasts, even if they were reconstructed, would mean I would cease to be a proper woman. I'd always taken my 38B breasts for granted before, but now I looked at them in a new light. I had successfully breast-fed both my daughters and they were still in good shape. They were a part of me and I couldn't simply cut them off, even if they did have cancer in them. Besides, having a mastectomy is a huge operation with many risks. There is the risk from the general anaesthetic - and the surgery involved in a mastectomy is very invasive. The consultant explained that to get all the breast tissue would involve not only removing my breasts but taking out all the tissue behind my breasts too, much of it buried deep into my chest. With a day to go before the op, I rang my consultant. "I can't face it," I said. He tried to persuade me to have it done. He told me it would help stop the spread of the cancer and ensure all of it was removed. I faced a terrible dilemma but I simply couldn't have it done. I knew friends and family were quietly horrified at my decision. Everyone said it was my choice, but I could tell by the look people gave me they worried I was mad. Instead I opted for a lumpectomy, an operation I believed would be just as successful and that, importantly, would leave my breasts intact. I then began six months chemotherapy. I didn't tell Joanne about my dilemma at the time because I felt she had enough to cope with and I didn't want her to worry that I wasn't doing all I could to survive. My daughters were fantastic in caring for me while I suffered through the chemo, but we never spoke about the one thing that played on our minds. Had I given them a death sentence? Terrifyingly, doctors say that because so many family members have been struck by breast cancer, even if they can't identify the exact gene, my daughters face an extremely high risk of contracting it, too. I feel so guilty that I've possibly passed on some rogue gene to my daughters. When I talked about it to Francesca in the New Year and tried to work out what she might want to do, she just shuddered. "I'll worry about the possibility that I'll get cancer in a few more years," she said to me. But then, a few weeks ago, Joanne said something that made my blood run cold. Sitting at home, we began to discuss what the future might hold for her, and suddenly she said: "I'll do anything not to go through cancer." It was the first time she'd brought up the fact that she, too, could be affected. Yet while I can understand why she wants a mastectomy, I feel Joanne is far to young to consider it. At first I thought it might be a kneejerk reaction; after all, it's not surprising, after she saw what I went through, that she can't bear the thought of getting breast cancer. She says she can't live her life properly with the worry hanging over her that she too may succumb to this terrible disease. It was devastating to hear her talk like that because I had no idea. And when she said she was willing to effectively mutilate her body to ensure her health, I was simply mortified. I told her straightaway I didn't agree with it. She is only 15 and as my child, she would need my permission for such an operation. I simply couldn't let her to go ahead with it. I can't help worrying she simply hasn't thought this through properly, because breast cancer isn't a death sentence. But then, can I really refuse, and perhaps condemn her to fight for her life in the future? Even if she does have a mastectomy, cancer can still occur in any tissue left behind, though it's rare. There is also the risk of infection. If anything goes wrong you could be left terribly scarred. And while Joanne can have a breast reconstruction at the same time, they will feel false, not like natural breasts and they won't have any feeling. She wants children but having a mastectomy means she won't be able to breast-feed. If I do agree that she can do it, she will almost certainly be the youngest woman to have a preventative mastectomy in the UK. My fear is that she will have this done, and then in ten years' time they may have come up with new treatments for breast cancer, perhaps even a complete cure. Then she will regret it for the rest of her life. Yet she is so terribly determined. I just pray I can convince her to wait.