National Breast Cancer Awareness Month
October is Breast Cancer Awareness Month. When breast cancer facts or statistics are reported from institutions such as the Washington State Department of Public Health Cancer Registry, we might ask ourselves—what does that have to do with ME? It has everything to do with you and me!
Sometimes breast cancer data isn’t what gets our attention or motivates us to perform self-examinations—which leads to early detection. It’s the personal stories of people who have lived the journey from early detection, to diagnosis, to treatment, to positive living. I know several colleagues and friends who have had breast cancer, including my mom. Fortunately, her case was detected early through self-examinations.
I would like to pass on the personal stories of two colleagues who have graciously agreed to share their experience of their breast cancer journey in hopes of bringing awareness to the need of early detection.
Personal Story #1—Be thankful and stay positive
I felt like something wasn’t right as I noticed changes in my breast. I thought it was just a part of the aging process. I thought, “I’m young, eat well, and exercise”—therefore, I ignored it until the changes started to get worse. I went to the doctor and had an ultrasound and biopsy. The diagnosis was DCIS, or Ductal Carcinoma in Situ. Initially, the doctors only removed some abnormal cells; however, after having an MRI, they found out there was extensive involvement. It was recommended that I undergo a mastectomy. That seemed rather extreme, so I obtained a second opinion. Again, the recommendation was to have a mastectomy.
When I made the decision to have a mastectomy, I was fortunate to receive support from my husband. He was fantastic through the entire process. I know not every woman is as fortunate. I also had two neighbors who are like family to me—and they both had breast cancer while I did. The three of us supported each other by sharing stories and offering encouragement when treatments and recovery seemed overwhelming. One of my dear neighbor friends had a more invasive form of cancer and has since passed away. My other dear friend is alive and doing well.
After my initial surgery, I have had three additional surgeries, including reconstruction. I also had radiation every week day for six weeks. I currently take a medication that blocks cells from taking up estrogen. This regimen will last a total of five years.
What have I learned from this experience?
- Don’t ignore changes in your body. Don’t think you are too young, too healthy, or too invincible.
- Keep a positive attitude. Our minds and spirits are important in the healing process. The doctors and nurses commented how positive I was through this journey. I kept an attitude of gratitude.
- Be thankful and build a support system. I am very thankful for the great support system I have with my husband and friends, and for the relationships I built with the doctors, nurses, and radiation therapists—everyone has been great.
Personal Story #2—Using family history as my compass
In 2012, in an effort to get my spouse to have a mammogram, I decided to schedule appointments for both of us on a Saturday morning. We’d have our mammograms, get some breakfast, and it would be fun!
Regular mammograms are important to me. My mother was diagnosed with metastatic breast cancer in the fall of 1999. She underwent a mastectomy. She started participating in clinical trials just after the new year in 2000. For the next eight years, she participated in every clinical trial that existed in North Carolina.
After eight years, she said “I’m done. I never planned on living forever and I’m sick and tired of being sick and tired.” She stopped all treatments and predictably, a year later, she started having seizures—breast cancer had migrated to her brain. A year later, she was complaining of leg pain which she attributed to the Dilantin she was on to prevent seizures. Because of that attribution, no one paid any attention to her complaints and, in May 2010, she could no longer bear weight. An x-ray showed that she had a fracture—breast cancer had metastasized to her bone. In August, her doctor noted some abdominal swelling but Mom declined to do anything about it. She knew—as we all did—that the breast cancer that was slowly making its way through her body had finally hit her liver. She died peacefully in her sleep three months later. Because of my mother’s diagnosis, I had been on the mammogram frequent flyer plan since I was in my early 40s.
Fast forward to January of 2012. We went for our mammograms and had a lovely breakfast up on Capitol Hill. A few days later, I got a phone call asking me to come back in for an “enhanced” mammogram. After the mammogram, the radiologist came out to speak with me. She showed me the scan of my breast and pointed out a line of little white dots—they looked like a tiny string of pearls. She told me that these were called microcalcifications, a precursor to breast cancer. They had been watching them for several years now—REALLY?!—and were starting to line up. This required further testing in the form of a stereotactic needle biopsy. That procedure was done 10 days later. A few days after that, I received a phone call informing me that I had cancer.
Many things went through my mind—shock, disbelief, why the heck are they telling me this over the phone, and many more. I had an appointment with the surgeon 10 days later. I took along a very good friend/co-worker (who also happened to be a nurse) and my spouse.
The surgeon told me that my DCIS was very easy to get to, very localized, and a lumpectomy was the treatment of choice, followed by radiation five days a week for several months. Given my experience with my mother and my strong desire to NOT be my mother 10 years down the road, I told my surgeon I wanted my breasts gone, period. No reconstruction, no nothing, just gone.
Since I carpooled to work, going to radiation every day would be problematic. The surgeon required that I get a consult with a plastic surgeon before she would schedule the surgery so I met with him a few weeks later. He determined that I was not a candidate for implants and was not a candidate for reconstruction of any kind until I’d completely healed from my surgery, completed all follow-up treatment—if there was any—and lost some weight. He authorized the bilateral mastectomy.
On April 12, 2012, 88 days after that vital mammogram, I underwent a bilateral mastectomy with the removal of two sentinel nodes. I had some bumps in my recovery and the surgical result was not what I was expecting so over the next 11 months, I had two revision surgeries. On the plus side, I did not require any additional treatments—no radiation, no chemo. On the minus side, I struggled—and still struggle—with tightness across my chest. I was doing what they call “guarding” immediately after my surgery. I would protect my chest by hunching my shoulders forward which had ramifications for my shoulders, neck, and back, so I spent some time in physical therapy. I and continued to do the stretching exercises several times a day.
Because my mother, her sister, and I all had breast cancer, I underwent DNA testing to see if we had a gene deficiency. Our family was understandably concerned about this. The result of the testing was that—apparently—three women in the same family can randomly get cancer, independent of each other. My sisters, cousins, nieces, and nephews all breathed a huge sigh of relief.
What started out as an effort to get my spouse checked turned out differently than I expected. Her mammogram was completely clear and I credit her with saving my life.
What have I learned from this experience?
- Keep a positive attitude. I am the epitome of optimism and research has shown that those who are more optimistic tend to have better outcomes.
- Take someone with you to your appointments. When you hear bad news, your brain shuts down a little. It is helpful to have someone there who is not emotionally involved and can hear what the doctors are saying. More importantly, that person can tell YOU what the doctor said after you stopped paying attention.
- Trust your instincts. The biopsy of my tissue from both breasts showed DCIS in 7 out of 10 sites in the cancerous breast and showed microcalcifications in the “prophylactic” breast. I was right, the surgeon was wrong.
Regular self-breast examinations are an important and easy step in early detection of breast cancer. Although the percentages are much smaller, breast cancer does not discriminate in gender—men get breast cancer too. When was the last time you did a self-examination?
Contributor Mary Pat O’Leary, RN, BSN is a planner at Aging and Disability Services, the Area Agency on Aging for Seattle-King County.