"Those feel great," says Sandra Gahlinger as she inspects Ellen Rosen’s reconstructed breasts. Rosen has had two mastectomies two years apart. At right is Lucia Fontes-Borts, of Barrington, also a cancer survivor. Second from left is Ann Hession, of Cranston.

The Providence Journal / Gretchen Ertl Gretchen Ertl

NEWPORT — The first things guests saw outside Sandra Gahlinger’s home on Tuesday were a dozen helium balloons and a piñata — all shaped like breasts.

The props set the tone for what Gahlinger called her “bon voyage to my boobies party,” her “fond farewell to my mammaries,” and her “ta ta to my ta tas.”

Yes, it was an unusual party theme. But then Gahlinger faced an unusual life crisis.

The party marked — no, celebrated — her decision to have a double mastectomy at the age of 38 as a result of a recent discovery of a cancerous growth on one of her breasts.

Only 5 percent of women diagnosed with breast cancer are younger than 40, according to the American Cancer Society. Of those, a very small and unknown number decide on double mastectomy as a treatment. And those who do often have a family history of breast cancer.

Three of Gahlinger’s aunts died from it. Her mother survived it.

Gahlinger intends to survive, too. But first, she feted her breasts, giving them a send-off marked not by solemnity, but levity.

“I am now going to do my impersonation of Dr. O’Connor,” Gahlinger said to the gathering of female friends and supporters.

That would be Dr. Francis O’Connor, head of surgery at Naval Health Clinic of New England in Newport. He’s Gahlinger’s doctor.

At a table with plates of sliced chicken breast and breast-shaped pasta, Gahlinger stood before a double-breasted cake, holding a knife and making a surgeon’s incision.

“It will curve just like this,” Gahlinger said. “I’m saving my nipples.”

Gahlinger’s saving herself, and, she hopes, other women, too, by publicly speaking out, countering convention and by putting everything that breasts may mean to her — a sense of identity, femininity and sexuality — into perspective.

“It’s my boobs or my life,” Gahlinger said. “The decision’s easy.”

Actually, the decision’s agonizing. Gahlinger admitted as much.

“It took me a while to find the humor in all this,” Gahlinger said. “I spent my fair share of time rolling on the floor, crying, going ‘Oh, my God.’ ”

Gahlinger’s diagnosis came gradually, suspiciously over 12 months, following a mammogram, a biopsy and, finally, an exploratory lumpectomy that caught her cancer at its earliest stage.

“The last year, I call my Tittie Twilight Zone,” Gahlinger said.“It’s been really strange.”

Gahlinger, a former elementary and high school teacher, went through a year of emotional turmoil, including a prolonged and self-induced pre-diagnosis despair.

“I equated breast cancer and young with death,” she said. “I had seen it with my aunts.”

Gahlinger also sought out a variety of sources of advice, beginning with traditional medical sources.

“You have to advocate for yourself. You have to understand your options. I read a lot of medical journals. I speak Latin now.”

LET’S GET back to the party. It’s getting interesting. The women are eating what Gahlinger calls “titbits” of food, and sipping “jug” wine. Everyone’s relaxed.

Bring out the breasts. As it so happens, all the women here have a couple. Some aren’t natural, since the invited guests include breast cancer survivors.

Ellen Rosen had two mastectomies two years apart. Now she’s looking good, so good, in fact, Gahlinger’s looking the Barrington woman squarely in the chest, suggestively asking, “May I?”

“Sure,” Rosen says.

“Those feel great,” Gahlinger says as she touches them.

Another woman touches, too, and then another woman.

“Anyone else?” Rosen says.

Rosen, who’s in an informal breast cancer support group, shares her health-care mantra: “Humor can be life-saving.” During her battles with breast cancer, she created a comic book: Coping; one breast at a time.

About half the women here are in the support group. Karen Hurley, of Barrington, started it a couple of years ago for three friends diagnosed with the disease. At the time, Hurley had already had a mastectomy. Little did she know, she’d need another.

“The group I started to support my friends became my support.”

Gahlinger’s mother, Betty Baker, has come from North Carolina.

“I admire her, at her age to have such a good outlook,” Baker says. “She’s always heard from me that it’s your attitude that counts. When something is done, it’s done. You take it and live.”

The women at the party, those who have had breast cancer and those who haven’t, applaud Gahlinger’s courageous, humorous and infectious spirit.

“It’s pretty awesome,” says Ann Hession, of Cranston, who met Gahlinger through a women’s business networking group. “I told my friends, ‘Guess where I’m going tonight?’ ”

None guessed pre-double-mastectomy party.

“She has had her denial and anger,” Hession says. “She went through it. She didn’t get stuck in it.”

A woman who had a double mastectomy has dropped her top. Naturally, she’s drawing attention.

“The shading is very good,” Gahlinger says, referring to the woman’s reconstructed and tattooed nipples.

This is all very encouraging to Gahlinger, who feared for a time she’d look like “Frankenboob.”

“Cancer is highly isolating,” she says. “There is hope. And you have to reach out to get it. One of the terrible things about breast cancer is unless you’re in chemo, people don’t know you’re sick.”

Toward the end of the party, Gahlinger approaches the bright pink piñata. She takes a white pole, holds it tightly in her hands, as though stepping to the plate with two out and the bases loaded in the bottom of the ninth, and swings for the fence.

“The piñata is my little anger management,” she says. “Beat the bad boobies.”

LAST DECEMBER, Gahlinger had a dream that changed her pessimism to optimism. A little man, smaller than a nickel, entered her dream, and her left breast. He stood near a medical marker previously placed there by doctors. He pointed just above it, and spoke to her.

“This is where the cancer is going to be,” he said, according to Gahlinger. “You have six or seven years to deal with it.”

Gahlinger didn’t wait. In January, by referral of a friend, she visited a doctor in Bennington, Vt., who talked about the mind-body connection and the power of personal healing.

Gahlinger was wary, but willing, having seen her late father will away chronic pain. Gahlinger became a convert. She decided to develop a Web site connecting alternative and traditional medicines.

In February, Gahlinger went to Washington, D.C., to a national conference of breast cancer survivors, where she heard a doctor offer a metaphor that calmed and comforted her.

“Breast cancer is a family of cancers,” the doctor said. “They all live in a boarding house together. Some are mass murderers. Some are petty thieves.”

“I have a petty thief,” Gahlinger said.

She received her official diagnosis on May 8: cancer. Technically, it was ductal carcinoma in situ. It was on her left breast; the spot cited by the tiny man in the dream.

Gahlinger said her cancer-recurrence rates vary with the treatment options, with the most likely recurrence resulting from a lumpectomy, the next with a lumpectomy and radiation, and the least likely with a double mastectomy.

O’Connor recommended lumpectomy and radiation. Gahlinger chose otherwise.

“I just thought, ‘Have them off.’ I had seen my aunts, and seen the cancer come back and come back and kill them.”

However, one of Gahlinger’s aunts lived 16 years with cancer, 10 times longer than doctors expected. Gahlinger attributes this to her aunt’s sense of humor, which she shares; so, apparently, does her husband, Lt. Cmdr. Greg Gahlinger, a student at the Naval War College in Newport. He supports his wife’s decision for breast removal and reconstruction. She says he describes it as “my hot rod is getting a flame job.”

O’Connor describes it as Gahlinger “maximizing her chances of never developing breast cancer.”

Greg Gahlinger didn’t attend the bye-bye breasts party. Gahlinger, in a soft Southern accent from her North Carolina upbringing, said it would have been too much for her husband, who she describes as “a Boy Scout.”

ON THURSDAY MORNING, Gahlinger underwent double mastectomy/implant surgery at Newport Hospital. She remains a 32D. Her new breasts she calls her “cancer consolation prize.” They’re a little fuller on top, but not to excess.

“I told my doctor, ‘No porn-star boobs.’ ”

When Gahlinger entered Newport Hospital for the operation, she wore mammary antennae on her head.

“I thought, ‘This is different,’ ” O’Connor says. “It’s not the usual response.”

But it’s a response O’Connor welcomes. “It’s a way to lighten things up. Life is too short.”

Gahlinger asked her anesthesiologist to recite a few written phrases she gave him to project positive energy into her as she was going unconscious. Just before the surgery, she imagined that bright white healing light would shoot from O’Connor’s fingers and instruments.

O’Connor noted none of that. However, he noticed something else. Gahlinger’s four-hour scheduled surgery took less than two.

“Her case went very well,” he says. “It was technically as flawless a case as you could have. Maybe her attitude had a positive influence.”

brourke@projo.com