A 60th-birthday party in the country. In a marquee. Dress code: 'Ethnic glamorous'. Well, hooray. That Alice Temperley halterneck maxi in my wardrobe, which I'd been padding around so nervously for months might finally have its outing. OK, so I was 48, OK, so my arms were a bit on the skinny side, OK, it went virtually down to the navel and was obviously designed with someone more cherry-pipped and nimble-waisted in mind, but it was, with its flower-girl border and Woodstocky feel, an absolutely appropriate outfit to wear for the occasion. More importantly, I had a killer tan that needed showing off. More importantly still, I'd be a lot younger than at least half the people there which meant it would be easier to get away with showing flesh. In a lot of people's eyes, don't forget, I'm still a mere spring chicken.

So, yes, that's what I wore, with a little strategically placed corsage from the haberdashery department of Peter Jones and emergency needle and thread tucked into my pants. And, yes, it was very nice to be told by a fellow guest, an octogenarian, well in his cups, that I had 'lovely separation'. Very nice to know that to a certain age sector of the population I was still fanciable, a bugaboo of mine as those of you who have ever read anything I've written will already know. At the same time, I wished to God I'd brought a cardigan or a shawl. Flaunting one's cleavage when one is a certain age is one thing. Flaunting one's cleavage when one's a certain age and has quite publicly just recovered from breast cancer is another.

It was last summer when I first discovered the lump, a couple of months after I had written a piece for this magazine on the topic of ageorexia. In the piece I explained my obsession with wanting to look younger than I actually was; how, even though I admired women who could grow old gracefully, and accept their genetic predisposition to middle-aged spread, I myself was never going to be one of them. It was the sort of piece that had a certain type of habitual (female) blogger hissing with rage.

I say lump. It was more like a grape seed, really, or a tiny, tiny little ball bearing and, having had implants, having been used to the lumps and bumps and irregularities that can happen when you've got two bits of alien silicone in your chest, I wasn't particularly worried. After the holidays, though, I happened to be sitting next to a friend at a party who had had stage-four breast cancer and a double mastectomy six years earlier. I asked her if she'd mind coming to the loo with me and copping a feel just to see what she thought. Hmm, I remember her saying, not like hers at all, but I should have it checked out anyway just for peace of mind.

And so I had it checked out, had the little lump removed by local anaesthetic, saw the little thing with my very own eyes (an innocuous flesh-coloured 'bobble' held up for me to see between a pair of tweezers) and pretty much forgot about it until I got the call the following week. Yes, yes, I remember saying, irritated to be interrupted while at work, can you just give me the results on the phone please, rather than having me come all the way in?

One of many lessons I learnt last year is that, if they make you come in, it's not going to be good news. And it wasn't. It was cancer and I had to go into hospital the following day to get another, larger lumpectomy and some of the sentinel lymph nodes from under my armpit dyed and removed in order to see if the disease had spread. Ageorexia. Growing Old Disgracefully. Hah. Was I in for a surprise. It was like that awful joke about the sergeant who is trying to figure out a way to tell one of his soldiers his mother has died. In the end he lines up his troops and says, 'OK, everybody step forward who has a mother... Not so fast, you over there, sonny!' That's a little how I felt when I thought of that piece I'd written. Not so fast, you over there, sonny.

It took one very long week to get the results. One very long week to think about the implications. In order not to think about dying, I fixated on the practicalities. How I'd tell the kids. How I'd still be able to work. What it meant about the way I'd lived my life thus far. And, last but by no means least, what effect it would have on my appearance. My hairdresser and close friend Josh, one of the first people I told, said not to worry about my hair if I had to have chemo, he had lots of clients who'd gone through it and, in every case, it had all come back. Around about that time I happened to interview Kylie Minogue. Very comfortingly she told me not only had hers all grown back, but it had grown back thicker, too. I wasn't that worried about the idea of a mastectomy, having gone through the squeamishness of implants. In a way I quite liked the idea of having them lopped off and thereby stopping the disease in its tracks (more of which later). No, what did worry me more, and I feel a little ashamed to admit this here, was the idea of having to take tamoxifen, the oestrogen-inhibiting hormone treatment associated with menopausal symptoms such as depression and weight gain. As someone who never in her life even took the mini pill for those very reasons, as someone who has become, over the years, bordering on the fanatical about body image, the idea of that was very, very scary indeed.

Good news, though, thank God.

It hadn't spread to the lymph nodes. I didn't have to have it lopped off. I didn't have to have chemo, maybe not even radiotherapy, so they said... To make extra specially sure it was good news, though, I went to the Memorial Sloan-Kettering Cancer Center in New York, famous for its somewhat hectoring, ultra-proactive attitude to cancer. They reiterated what I had been told in London, but told me, contrary to the advice I'd been given at home, that there was no question I needed radiotherapy. They also told me I'd be 'nuts' not to take tamoxifen. But I didn't need to decide on that yet. I had a few months.

So I went ahead with the radiation - which meant lugging myself to the clinic every single weekday for six long weeks to get zapped. It was fine. I got myself a little routine going. I spent a lot of money in the shops nearby. Unlike many women I've talked to who have had their breasts irradiated I didn't get tired or sore at all and I didn't get lymphoedema (from the extraction of lymph nodes) either. What was horrid was the humiliation of getting topless and having to assume these kinky positions with my arms pinned behind me in front of strangers. That the zapping room didn't actually have a door - anybody could wander in and out while I was in there - was a little creepy, too. To stop myself getting into too much of a lather about it, I'd practise my pelvic-floor exercises while it was happening, and after six weeks, believe me, one can shoot ping-pong balls.

Soon enough it was all over. Eight months on I am absolutely, utterly OK. No, more than OK. Indeed, when I think of my friend Stevie, who was four months' pregnant when they found her tumour - 8mm compared to my piddling 5mm - and then lost the baby right before having treatment; when I think of my friend Rola who had to pretend to her three-year-old that she had had her head shaved for Halloween when he caught her without her headscarf on; when I think of any of those poor, war-torn, headscarved women I saw in my oncologist's waiting room, swollen on thalidomide or sipping on frappuccinos before going in for chemo (iced drinks apparently help with the nausea). Oh, goodness, when I think of how lightly I got off, it feels downright fraudulent to consider myself part of the cancer sisterhood.

I am so not the only gay in the village, as I have to keep reminding myself whenever the temptation to play the cancer card arises, which it does from time to time. See, there's part of me that likes playing the victim, and cancer plays nicely into that role. It's the reason, I'm sure, why I encouraged myself not to comfort eat throughout radiotherapy, as many women do, so as to at least look the part of Someone Undergoing Cancer Treatment. It's the reason, too, that I had the habit of subtly weaving the subject into conversation at table, getting slightly miffed when friends didn't bring it up and also getting slightly miffed when they looked so surprised that I looked, so, well, normal. God! My poor friends! How did they ever get it right? (A belated thank you, by the way, to my friend, the writer AA Gill who, when I delivered my news in the best Brave Little Soldier voice I could muster, merely said, 'Cancer? What? Fabulous! Which part?' Thank you, Adrian, for putting me in my place.)

At the same time, I did have it. I am that one person in whatever. And I've got the war wound to prove it. There's a chunk taken from the side where they did the lumpectomy. Thanks to the radiation, my breast implant has encapsulated and is therefore much harder than the other one. Oh, and it's also a bit blue from where they pumped all that dye into my lymph nodes. And, as much as having cancer plays conveniently into the poor-little-me role I sometimes ascribe to myself; as much as wanting to be a sort of poster girl for the disease (as a journalist I feel it is my moral duty to write about it and hopefully help other breast-cancer survivors not feel like pariahs); as much as I have, since recovering from the disease, vastly revaluated some of my priorities, I haven't changed my personality. In other words, getting cancer didn't stop me wishing I looked younger than my age, of toying with a face-lift, or getting angry with myself for eating all the crispy bits at the bottom of the roast-potato bowl. Or, indeed, after much toing and froing, hating the idea of tamoxifen.

Is that putting vanity over health? Jo Malone [the woman behind the fragrance brand] who herself suffered breast cancer and a double mastectomy, and was such a comfort to me during that long week of waiting, might think, yes. My equally proactive and sensible friend Anya, who told me to think of it as 'a nasty verruca' when I called her the night before the operation, might also think, yes. My American doctors for sure would think, yes. Me, I don't know. By not taking it I have increased my risk of getting cancer again in that breast from 0.25 per cent to one. I could still get it somewhere else and, as we know, my body is quite a safe haven for cancer cells. Aside from that, to me the stress I'd have from the drug's potential side-effects far outweighs the stress of worrying about potential recurrence, and if stress is supposed to contribute to cancer, maybe it's not such a frivolous decision to make.

This poor blue 'divoted' tit of mine, meanwhile, which I'd hoped to learn to love as part of me, hasn't quite happened yet. It's fine in the right bra or bikini top but in the showers at yoga, or indeed the hot springs we visited with friends in Colorado this summer, well, that was something different. Should one be out and proud like the woman I saw on a crowded beach in St Tropez recently, bathing suit rolled down to the waist with her mutilated flat side exposed for all the world to see? Or is it better, politer, more decorous among company, to cover it up? Typically, I couldn't make my mind up and ended up getting into the hot springs totally naked, with hand apologetically glued to gammy tit throughout. Like the heroine in Marisa Acocella Marchetto's best-selling graphic novel Cancer Vixen (which is being made into a film) I can't help feeling like damaged goods.

One's self-esteem should be such that it doesn't matter, of course it shouldn't - at-my-age-and-aren't-I-lucky-to-be-alive sort of thing - but do you know, it does matter. It jars with the, let's face it, slightly MILF-ish image I have of myself. OK the last thing in the world I need or want, at this point in my life, is to have a fling with a younger man. But still, that doesn't stop me wanting to look like I could.

Which is why I haven't ruled out the possibility of lopping them off and, as it were, starting again. Having had 'fake' tits for nearly eight years now anyway, it doesn't seem such a jump and, if truth be told, I'm sick of having such big boobs for my frame anyway. I'd much rather have boobs like, say, my new 'cancer-club' buddy Lucy, a former over-shoulder-boulder-holder type of gal, who, after her preventive double mastectomy now has (thanks to the latest breast-reconstruction techniques) bosoms so perfect she doesn't even need to wear a bra. And my halterneck dress? I wouldn't have felt weird or inappropriate or passive-aggressive or indeed anything other than pleasantly drunk if I'd had breasts like hers. Seriously, what's not to like?

Well. On paper, quite a few reasons. I'd have to get new nipples (they form a kind of 'bud' with your own skin and then, at a later stage, you can have the area tattooed to look like you have an areola), quite apart from the fact that, erotically speaking, they'd be completely numb. I wouldn't have the support of my other half, either, who, though not a tit man, reacted like I wanted to have my arms or legs cosmetically amputated when I broached the idea. And if I thought it would give me more years, I should disabuse myself of the fact, pronto.

A study I came across in the New York Times on a group of cancer patients at the Mayo Clinic in Minnesota showed that those who have preventive mastectomies as opposed to what I had - lumpectomy and radiation - don't survive longer statistically anyway. I interviewed an American expat who had had a double mastectomy last year after being diagnosed with grade-three cancer in her left breast (and now, after reconstruction, has the breasts of a 20-year-old); she warned: 'Think very hard before you go ahead. It's a much bigger deal even than it sounds.'

Using cancer as an excuse to get better breasts. Is that ethical? Probably not. But still. Being the sort of person, as Jennifer Aniston once put it, who defines herself by her body, being the sort of person who, however much she spiritually evolves will always, to a certain extent, define herself by her body, I cannot totally rule out the possibility.

Cancer has naturally made me reassess what counts and what doesn't. I'm much better at living in the present, I'm much more involved in my children's lives, I'm much more aware of how precious life is and how swiftly it can be taken away from us. I've also realised how much energy hating someone or something takes up; how accepting people's foibles leaves you room, selfishly, to do so much else. And yet. I am still the same person. The same person who posed in a miniskirt for this magazine just over a year ago, and worried about her wrinkles. I hope I have the same attitude this time next year. But I won't bank on it. One never knows what the future holds...

• October is Breast Cancer Awareness month. For more information, see www.cancerresearchuk.org