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From Gossip Girl to the Real World

Consider the prophylactic mastectomy

“To cut off my breasts, or not to cut off my breasts.” This is the existential question facing 34-year-old television writer Jessica Queller, who has tested positive for a genetic mutation that gives her up to an 85% chance of getting breast cancer and puts her at high risk for ovarian cancer.

In her memoir Pretty Is What Changes: Impossible Choices, the Breast Cancer Gene, and How I Defied My Odds (Spiegel & Grau, $24.95), Queller, who works on the popular high-school drama “Gossip Girl,” discusses the agonizing decisions she must make, given the likelihood that she’ll develop cancer. She could opt for frequent screenings, with the hope that her doctor would find a malignancy in its early stages or choose a prophylactic double mastectomy; if she chooses the surgery, it would be followed by breast reconstruction — the menu options for which the author writes is “as long and nuanced as Starbucks’.”

And then there is the matter of her ovaries. A mastectomy would significantly decrease Queller’s risk of breast cancer, but only the removal of her ovaries will lower her chances of getting ovarian cancer — the disease that killed her mother, but not before turning this energetic, middle-age woman into an invalid.

These possibilities weigh especially heavily on Queller, who is single and longs for marriage and children. “If I had a mastectomy and reconstruction, would men no longer find me desirable?” she wonders. “Would I feel deformed? Would I ever want to be touched again? Would I no longer feel like a whole woman?”

Despite the gravity of the choices she’s confronting, “Pretty Is What Changes” — taken from a line in the Sondheim musical “Sunday in the Park with George” — is not a maudlin tale. Queller lightens her memoir with anecdotes about her friends, her high-powered colleagues on the Warner Brothers lot, her adventures in dating and her fashion choices.

The story unfolds organically — that is, until the end, when the narrative flow is interrupted by a summary of the questions and ethical dilemmas posed by genetic testing. Here, Queller cites statistics, quotes newspaper articles, and skims over topics such as the engineering of embryos and the circumstances in which would-be parents choose to abort a pregnancy. This reporting could have been expanded and woven more seamlessly into the course of the narrative. Still, Queller, who has penned scripts for “Felicity” and “The Gilmore Girls,” proves with this book a knack for storytelling that transcends the teen-drama genre.

Gabrielle Birkner is a writer in New York.