Discussing Breast Cancer

Can’t figure out what to get that special survivor in your life? Think out of the box — the greatest gifts will let her know you think about this illness that has become a part of her life

How about a mammogram? Gift wrap an appointment card and put it in with a gift card bag. She’ll appreciate knowing that you’re taking your health seriously because of her.

What about genetic testing? A mother can do this for her daughter, a daughter can do this for her sisters, a husband can do this for his wife and kids (yes, even men should consider this test if breast cancer runs in their family).

Coupons to cut? I’m sure you crafty guys and gals could make a coupon book offering up rides to/from appointments, babysitting when she wants to drive herself, company when she doesn’t want to be alone. Use your scrapbooking/craft supplies and make it personal and pointed.

Of course, you can always hit up the Pink Ribbon shop or Presents for Purpose. Nothing like a pink ribbon somethin’ under the tree!

breast cancer, cancer, Christmas, gifts, survivor

I’ve been putting off sharing the details of my recurrence because recurrence itself is so hard to face, even after the fact. I also don’t want to worry anyone unnecessarily … not everyone has a recurrence after an initial bout of breast cancer. Many, many people are lucky that way. I was not. This week I’ll tell you about my recurrence.

After my treatment for DCIS in 2003, as I said before, I went on Tamoxifen and intended to stay cancer free. After all, my breast cancer was Stage 0, my surgical margins were good, my radiation treatments were clinically ‘by the book.’

Good doctors monitor you closely and I did my part by making and keeping my scheduled appointments.

A few months after my treatment (March 2004) I had a clean mammogram. That was a huge sigh of relief — everything looked sunny, not a calcification to be seen. I didn’t have to have another mammo for a year. The weight on my shoulders was lifted. That year was fantastic. My energy returned and physically I felt great.

Mentally, however? I was afraid of recurrence. They didn’t have good data for young survivors — i didn’t want five or ten year recurrence rates, I wanted twenty or thirty year rates and they don’t exist for women under forty. One of my doctors told me that since I was diagnosed, odds were I’d get cancer again in my lifetime. “The good news,” he’d tell me, “is that we’ll be on top of it when it happens.”

That’s such a frustrating concept. After you’ve been diagnosed with and treated for breast cancer, you’re always waiting for the other shoe to fall and hit you in the head. You always expect it, you just don’t know when it’ll happen, so you’re never quite … at ease.

My March 2005 mammogram was different from the previous year, but not suspicious enough to warrant a biopsy. Six months later (September 2006) I had another mammo, no different from the March mammogram so still not suspicious enough.

Both times I felt I’d been given a recess but not a permanent vacation from the worry.

Then came the March 2006 mammogram … and the other shoe finally fell from the sky.

A study that was in the news last week after it was published in the New England Journal of Medicine showed that expensive, high tech mammography machines didn’t help radiologists “find more tumors and significantly increased the number of false alarms.” I read about this study and the scrutiny these pieces of equipment are under in an article in The Washington Postthat highlights the debate about mammography screening in general. This whole issue begs the question: what is better, a false alarm from an imperfect screening measure (an area of the breast that look suspicious but in actuality, is not) or an undiagnosed cancer?

As someone who was diagnosed with breast cancer at age 35 at an early stage, I say the latter. I would rather go through a litany of tests and find out I didn’t have cancer then have cancer and not know about it.

Then Reuters releases this information today: women who experience a ‘false positive’ are more likely to do self-breast exams and more likely to return for subsequent mammograms. However, they experience higher levels of anxiety than they should have to when it comes to a routine screening procedure and that anxiety can have lasting effects. Hello? Anxiety? Imagine the anxiety of getting diagnosed with a breast cancer that had been growing in your body undetected and unbeknown to you for years and learning that had you been screened your cancer might have been detected earlier and you might have had a better chance to fight the disease and live if you had gotten regular mammograms? Is there really a comparison?

(Thanks to Soochal at Flickr for the beautiful photograph.)

You might question when you should get a baseline mammogram, when you should start getting regular mammograms and how often you should get mammograms once you start. Even the guidelines can be confusing:

This is so dangerous … it makes me nervous just thinking about it!

Yes, there are risks associated with mammography primarily because it is a form of radiation, like an x-ray.

But mammography saves lives (just read this information based on an American Cancer Society study).

Fewer women die from breast cancer after mammography becomes routine.

Let me say that again … fewer women die from breast cancer after mammography becomes routine.

Cancer caught earlier responds better to treatment.

If I didn’t go for that baseline mammogram when I was 35, the cancer that was growing in my body would have gone undetected for at least five years until I went for my first mammogram when I was 40. If I didn’t go for that mammogram when I turned 40 … well, I can’t even speculate, but I’d venture to guess that I wouldn’t have had a curable disease.

Remember … I didn’t have a family history of the disease. I didn’t have a palpable lump. I had a strong sense that something was wrong with my body and I acted upon it.

There are no studies to back up that reason for getting a mammogram. Just common sense.