A 25-year-old Williamsburg woman is about to cross one of the biggest finish lines of her life, then head straight into one of the hardest decisions she's ever made. Jessica Reilly plans to run this year's TCS New York City Marathon just two days before undergoing a bilateral mastectomy, a surgery she chose after testing positive for the BRCA1 gene mutation.
Reilly's path to that decision took roughly a year of appointments, research, and what she described as an exhaustive search for answers, according to ABC7 New York. “I spoke with what felt like every doctor in New York City,” Reilly said. The outlet reports she ultimately decided against a path of ongoing monitoring in favor of surgery, telling the station, “I knew that I wanted to go the prevention route.”
Her family's history with cancer runs deep. Reilly learned the BRCA1 mutation came from her father, who was diagnosed with non-Hodgkin's lymphoma when she was 11 years old and later recovered, the station's report notes. She has said her parents both endured chemotherapy, and that cancer has touched her family repeatedly.
A Training Scare That Echoed Her Mother's Illness
The weight of that history surfaced in an unexpected way during marathon training. Reilly hurt her back while preparing for the race, and the pain mimicked symptoms tied to her mother's cancer, she said. “I had hurt my back, and it was mimicking symptoms of my mom's cancer,” Reilly said, per the same account. Despite the scare and the surgery looming just two days after the race, she has described the act of running the marathon as difficult but meaningful.
What Doctors Say About BRCA1 Risk and Options
Dr. Elisa Port, chief breast surgeon at Mount Sinai, said people who test positive for BRCA have more than one path forward. Port said screening typically starts early: “we start MRI's at age 25, and then we typically add mammograms at age 30,” she said. Port added that a woman can continue on that surveillance pathway for as long as she wants, rather than moving straight to surgery.
Port also encouraged people with unclear family cancer histories to seek answers and ask questions, noting that some people develop cancers unrelated to BRCA at all. The American College of Obstetricians and Gynecologists lists screening tests, medications, and surgery as the recognized prevention options for people who test positive for a BRCA mutation, according to ACOG. The organization estimates a lifetime breast-cancer risk of 45 to 85 percent by age 70 for people with a BRCA mutation, and a 39 to 46 percent ovarian-cancer risk by age 70 specifically tied to BRCA1.
Surgery Ahead, and Risks That Don't Fully Disappear
Reilly is expected to undergo additional reconstructive surgery after her mastectomy, and she will continue to face an elevated risk of ovarian cancer even after the procedure, per ABC7's reporting. The mastectomy itself is aimed at prevention rather than treatment of an existing cancer — Reilly has not been diagnosed with the disease.
She's not the first New York City Marathon runner to carry a cancer story across the finish line. In 2024, runner Courtney Knights ran the race to honor her late grandmother, who died of breast cancer, and had multiple preventive surgeries planned afterward that were expected to lead to a double mastectomy, according to an earlier ABC7 New York report.
The 2026 TCS New York City Marathon takes place Sunday, with Reilly among the thousands expected on the course. Her surgery is planned for two days later, according to the station's reporting — a tight turnaround between a 26.2-mile test of endurance and a procedure she has spent a year preparing to face.
