Bianca Balti: 'I had both breasts removed to prevent cancer. Then it came for my ovaries'

By Bianca Balti

I only had the BRCA gene test on a whim really, without fully understanding what the repercussions might be, or how dramatically the positive result would come to shape my life.

It was back in the summer of 2021 when I first noticed that some lymph nodes in my armpits were enlarged. I was then 37, a divorced single mum of two, with a successful modelling career which included fronting years of Dolce & Gabbana campaigns.

I wasn't old enough to be eligible for a mammogram in Italy, my home country, so I paid to have one in Los Angeles, which had become my base when not travelling for work.

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My paternal aunt died 15 years ago, aged just 39, from metastatic breast cancer. I didn't want to take any chances.

I was relieved to get the all-clear at that mammogram, but after I'd mentioned my aunt, I was offered a BRCA test – which looks for DNA changes that increase the risk of breast cancer and ovarian cancer – for free. I'm phobic about needles, but once they assured me it was just a saliva test and there'd be no charge, I shrugged "why not?"

A few days later I received a call that changed everything: "You've tested positive for the BRCA1 gene mutation."

I was stunned. Later, during an in-person consultation, I learnt that I had a much higher risk of developing breast cancer (over 60 per cent) as well as ovarian cancer (between 40 and 60 per cent). It was recommended that I have my breasts and ovaries removed.

The news left me reeling. I didn't tell a soul for months, pushing the anxiety to the back of my mind. I carried on spending the summer in Italy with my daughters.

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For any woman the idea of removing body parts – breasts that have nursed babies, ovaries that still held the potential of another child – is emotional. And as a model, my livelihood rests on my looks. I wasn't ready to deal with it.

Then, at my 38th birthday party in March 2022, I happened to chat to a woman the same age as me who was wearing a headscarf having just gone through ovarian cancer. When she told me she had the BRCA gene, I opened up for the first time about my own BRCA status.

This new friend had known she carried the gene but had delayed surgery to have children – and by then, cancer had formed. It was quite the wake-up call.

After that I went for several consultations with different surgeons. Most recommended removing the breasts first, since my family history was stronger on that side.

I was aware of the Hollywood actress Angelina Jolie's surgery, but I didn't know anyone personally. Most of my friends and family thought I was mad. "You're not sick, why would you remove perfectly healthy body parts?" they said.

But I felt it was the right thing, so in December 2022 I underwent a double mastectomy. I already had implants so it made sense for me to undergo reconstructive surgery at the same time, and having successfully overcome my addictions to opioids 10 years earlier, I requested no strong pain relief.

It might seem shallow, and my life was clearly more important than my looks, but of course there were concerns about the results and whether I'd work again.

Luckily I had an amazing surgeon, she made me feel safe and praised my bravery. I needed that. And when I awoke from the surgery I wasn't grieving my old body; I felt overwhelming relief that I'd taken action and would never get breast cancer.

I always knew more surgery – to have my ovaries removed – was needed in the future. Yet I also still hoped to have more children, I'd frozen my eggs at 35 after a break-up.

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The idea of closing that door permanently was too painful. Admittedly, I also feared menopause and what it would mean for my skin, my sex life, my energy. You hear so many negative stories.

I decided to put off the ovary removal but went for checks every six months: the last one I'd had, in May 2024, was fine.

Yet by that summer, I began feeling bloated and despite the fact that I was eating clean and staying fit, I still felt "off". Friends told me I was being paranoid: "You're so skinny!" they cried. Perhaps I was just being a paranoid model.

Then, in September, during a weekend when I'd taken my daughters to Ojai in California, I started getting such severe stabbing pains in my left lower abdomen (at first just when I went to the bathroom and then pretty much all the time) that I could no longer ignore it.

I ordered the girls pizza and told them I was just going to get checked out. I'd suffered a hernia when I was younger and wondered if this was causing the pain.

I drove myself to the ER at Providence St Joseph hospital, feeling certain I'd be sent home for wasting their time.

Instead, after blood tests and scans, a handsome doctor who looked more like a movie star came in and casually announced: "It's a real mess down there." Oh, I thought. Then he added: "You have cancer."

It was surreal, I was alone, frightened and burst into tears. I cried and cried, beating myself up for being an idiot and not having had my ovaries removed earlier. I called my 72-year-old dad back in Italy and broke the news to him, sobbing down the phone.

I knew I had to be honest with my daughters, waiting until after school the next day and telling my younger one: "Mummy has cancer, but she's going to get treatment and be OK."

I prayed this was true. I've always been superstitious and I rang my friend who reads tarot cards. "Am I going to die?" I asked my friend. She pulled out a card and said that I'd have surgery and that I'd live.

I stayed in hospital as more tests were needed to see where the cancer had spread. Initially it didn't seem like surgery was an option (so I thought my tarot must be wrong) but then – in a miracle – the doctors decided it was possible. They operated the next day.

My cancer was classified as stage 3C – it had spread across my abdomen, from diaphragm to bladder, but they removed what they could.

Four weeks later, chemotherapy began. That was brutal. I knew seeing my hair come out in clumps would devastate me, so I cut it into a bob initially, then a pixie cut and then – when I knew it would only get worse – I decided to shave it all off on Hallowe'en night.

I wanted to dress up as Uncle Fester from The Addams Family and try to own the situation. But actually, I learnt that shaving takes much longer than I'd thought, especially as I only had a razor for pubic hair!

After surgery, I was plunged into immediate menopause, with intense hot flushes as soon as I was home five days later. I'd wake up drenched in sweat, exhausted, depressed. Oestrogen patches helped immensely.

In fact I felt so normal for a while that I stopped using them because I was worried I'd gain weight. But later the symptoms returned and my mood crashed. I went back on them this summer and it's really helped lift me.

I think what's often not mentioned about cancer is how you feel afterwards. The diagnosis is frightening and then after the treatment you're in survival mode with adrenalin pumping. Even just two weeks after my final chemo I flew to Italy to co-host Sanremo Music Festival, feeling buoyant in my fabulous gowns but with barely any make-up and showing off my bald head.

But nearly a year on from the life-saving operation, I'm left asking: what now?

I'm incredibly grateful to be alive, but I now want to do something more fulfilling than just modelling.

I'm taking a mental pause to reflect on what's happened and I've started therapy again. I've had to accept the pain of knowing that I didn't have my ovaries removed in time, stop beating myself up and move on.

This disease doesn't discriminate. Even children – heartbreakingly – can develop ovarian cancer. I've met young girls going through chemo. If my story can help even one person catch it early, it's worth me telling it.

Doctors are making real progress and I'm backing the campaign for new tests being developed that will detect ovarian cancer earlier so more women have a better outcome. My own daughters will make their own decisions about taking the BRCA gene test when they are ready.

It's not advised to have it before the age of 21 and then there are wider implications to consider, from the emotional ones regarding children, for example, to the practical – you cannot get life insurance with a positive result.

I'm lucky enough to have a platform because of my work, so I want to use that to help other women.

That's why I'm collaborating on the "Ovaries. Talk About Them" campaign by fashion label Camilla and Marc to promote the work it's doing to get the world's first DNA-based early-detection test to clinical trials in the next year.

Since I've been honest about my hurdles I've had women hug me in the street and write to me saying they've booked their first check-up because of me. That's given my life a new purpose. More important than any magazine cover is the knowledge that I might have helped someone else.

As told to Susanna Galton

Ovarian cancer: the facts

Ovarian cancer – known as the "silent killer" because it's notoriously hard to detect in its early stages – is one of the most lethal and least understood cancers today. In the UK, there are around 7,500 new cases every year – that's 21 every day. 28 per cent of all new cases are in women aged 75 and over. Age is a risk factor, as is having fewer, or no children, and getting early periods. Unlike many other major cancers, there is still no routine, reliable early-detection test for ovarian cancer.

Dr Kristina Warton is part of an Australian research team working on a world-first DNA test for early detection of ovarian cancer, which she hopes will go into clinical trials next year. Here she answers some frequently-asked questions.

Why are rates rising?

Ovarian cancer is rising because lifetime risk factors, such as having few or no children and earlier periods, are increasing. These contribute directly, but also by changing our demographics so that our communities simply have more people who are older – which is itself a risk factor for ovarian cancer.

How much is hereditary?

Around 20 per cent of ovarian cancers happen because people have a genetic predisposition – they've inherited a gene variation that makes the cancer more likely.

This test can detect both cancers that are genetic and cancers that are not genetic. We have designed it such that it can detect some of the less common types, as well as the most common one, so we have tried to make it work for as many people as possible.

Can ovarian cancer be prevented?

There are some factors that people have a degree of control over, such as not smoking, breastfeeding their babies for longer (if that's possible), and maintaining a healthy weight. Unfortunately, at the moment, the only way to definitely prevent ovarian cancer is with prophylactic surgery.

Hope on the horizon

The Ovaries. Talk About Them campaign, now in its sixth year, has an ambitious goal: to help bring the world's first circulating tumour DNA-based early-detection test for ovarian cancer to clinical trials by 2026. This would be a world-first breakthrough.

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