My cousin Stephanie gave me a picture of Tammi and me at about ages 4 and 5. In this tiny, black-and-white photo, our hands are clasped as we stand on the sidewalk in front of our home, smiling. We are two sisters in matching denim overalls; we look very "country" because we were! In the background is a '50s-era car (how could that be?!), parked on a street in Cumberland, Md. Looking at the picture reminds me we are still joined — she in the afterlife, me in this world — connected through love and our common disease.

Tammi was born only 14 months after me, so we were very close. In our 30s, we made a pact to be like the Delany sisters: living well beyond 100 and sharp as tacks. Presumably widowed, we would live together. Tammi, always tidy and elegant, would wear a trench coat, even in summer. I, less organized but lovable, would be searching for lost keys, glasses, and other effects from morning until night.

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Our treasured plan was disrupted when Tammi was diagnosed with breast cancer at age 33. Somehow, this brought us even closer. We talked by phone for hours after her diagnosis; I slept in her hospital room after surgery and walked the oncology ward with her; we shopped after her radiation treatments; I fed her ice chips in her final days of hospice care at my house. I held her in my arms when she died at 36 in 1995.

About a month before Tammi died, I promised her I would take care of my own health and breasts. Those final days were so precious, but that day I made the promise to her was particularly special.

Since Tammi's diagnosis, I've dutifully followed my annual routine: procrastinate, make the mammogram appointment, show up, don the gown, have my boobs squeezed like they were being run over by a steamroller, and then wait in a little cubby, holding my breath and hoping this won't be "the time." For all those years, I exhaled and thanked God as I got the results.

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Last June, my time came as I was flirting with Scott, my husband of 13 years. That sunny day in our kitchen, I flashed him playfully, lifting my tank top for about 10 seconds. In that time, Scott noticed a little crease on my left breast. It was so tiny you could see it only with my arms raised, and barely then. But I knew what it meant. If you've lost someone you love to breast cancer, you know.

As usual, my mammogram showed no sign of problems, but the sonogram certainly did. On my daughter Sara's last day as a second-grader, I received the pathology results.

Mammogram, sonogram, and biopsies all happened in rapid succession. My family and friends were ready to circle the wagons. Red-winged blackbirds — my favorite — were everywhere in my neighborhood the day we got the news from my breast surgeon, and I knew they would be no less beautiful if I had cancer. Results: two malignant tumors in my left breast — exhale. "OK, I've got breast cancer."

How could both beaming little girls, hand in hand in an old photo, have grown to develop this disease? Maybe Tammi and I shared a genetic mutation that contributes to developing breast cancer. Our first cousin Carol had breast cancer, a few years back, in her early 50s. Her cancer was caught earlier than mine, requiring a lumpectomy, but not chemo or radiation. A second cousin, Dolores, also postmenopausal, had an experience similar to Carol's. Like many African-American women, neither Tammi, Carol, Dolores, nor I had gotten genetic testing and counseling.

This image was lost some time after publication.

Family photo

The author Terri Nimmons and her daughter Sara.

I finally had genetic testing in late August, and it revealed I do not have any of the known genetic mutations for breast cancer. That's good news for the women and girls of my family, but it wouldn't have changed anything for me, even if I'd known last summer. A week before my mastectomy, I decided to have my healthy right breast removed, too. Intuition was guiding me, so once I made up my mind to do it, I was fully at peace with the decision.

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Having seen breast cancer and treatment up-close, I thought I knew what to expect. But I really didn't. Nothing can prepare you for making your way through this stuff. As a businessperson accustomed to making quick decisions, I stumbled through dense medical information, opinions, treatment options and my own pathology reports. I leaned heavily on those who love me. Scott, my brother, cousins, in-laws, and friends were always with me — kind of like those Verizon network ads, only better. Having watched Tammi waste away from the same disease, they were suffering — but they never let me see their fear or their pain. Through their love and memories of Tammi, I have remained happy, grateful, and without fear (most of the time).

Everybody has helped me get through the hard work of keeping Tammi's experience and her fate distinct from my own. Much has changed since she had cancer, yet the prescribed treatment for me was grimly familiar: mastectomy, chemo, reconstruction, radiation and Tamoxifen. Difficult, to be sure, but lifesaving.

Now I'm through most of the tough stuff: I've been chemo'd and radiated, and my new breasts are under construction and coming along nicely. The treatments I received were prescribed to cure me, and that's what I believe. I belong to Women Warriors — an amazing group of women and definitely not your typical support group. My loving network still surrounds me, and my husband and daughter are settling into our new normal.

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Breasts are so integral to being a woman that you can't imagine (unless you're going through it) having them removed and replaced. My new breasts are a little bigger and I say, "so what?" Increasing breast size as a result of illness is not a change any of us would willingly choose. My daughter, Sara, notices that my hugs feel different. When I look in the mirror each morning, I see scars that healed beautifully where nipples used to be. And, as I look to the future, I hope to regain more feeling in my breasts. Self-image, appearance, sexuality, health and peace-of-mind all disrupted at mid-life – a stage of life Tammi never knew.

Not having my real breasts hurts, literally and in other ways. Yet, life is so good and still a daily miracle. Breast cancer has taken two things from me. My sister isn't one of them. Through everything, Tammi has been my quiet companion, holding my hand, keeping our connection. Having shared so much with her, this one more thing seems almost natural.

Terri Nimmons and her husband, Scott David, are principals of Stone Lake Leadership Group, a leadership consulting practice. Terri is happily back to balancing her family and work lives. She has created a website for professional women with breast cancer: www.life2lead.com .