I woke up in Bangkok, Thailand, and watched the morning sun light the smoggy sky to a whitish-yellowish gray. I’m in this city for a doctor’s appointment related to my breast cancer diagnosis last year. It’s ironic: today happens to be World Cancer Day, according to the Thai morning news shows I flipped through as I drank coffee. It’s also Chinese New Year’s Eve for Year of the Pig.
World Cancer Day is to “raise awareness” about the dreaded disease. I think we’re all aware of cancer by now. But as a breast cancer survivor, I want to offer a specific message of early detection with 3D mammograms. This helped save me from a definite course of chemotherapy and other drugs.
A 3D mammogram found a large, suspicious area in my left breast. My next step was a stereotactic biopsy, which also is guided by 3D imaging. That biopsy found ductal carcinoma in situ (DCIS) – the earliest form of breast cancer. At that point, I was diagnosed with Stage 0 breast cancer – the earliest stage.
The DCIS area was large, relative to the size of my breast. A lumpectomy was never an option. Doctors said my chances were higher than average for the cancer to form in the other breast. My family history is rife with breast cancer. For 20 years I heavily drank alcohol; smoked a pack of cigarettes a day; exercised sporadically; ate junk food often; worked many years on the ‘overnight’ shift. All of those lifestyle factors – and more – increase a woman’s risk. So, I had a double mastectomy.
Here’s the kicker: when the final pathology results came back after my double mastectomy, I was upstaged. Even the best digital imaging didn’t catch a tiny, invasive ductal carcinoma tumor near the DCIS area. I was ultimately placed at Stage 1a breast cancer.
A 3D mammogram and a stereotactic biopsy both failed to see this invasive tumor that was 1.5 millimeters in size, which is a tad larger than the period at the end of this sentence —>. You aren’t going to feel that on a self-examination of your breast. At least the 3D images picked up a suspicious area, which led to the discovery of the DCIS, which led to the removal of the breast, and the ultimate discovery of the invasive cancer.
On this World Cancer Day, I urge all women who have yearly breast testing to get a 3D mammogram. Definitely please do this if you are at high risk, and also if you are not. Here is why.
During my ongoing emotional recovery, someone close to me basically said: ‘I told you so. I tried to warn you about your unhealthy lifestyle over the years.’ Yes, I lived an unhealthy lifestyle for many years, as I have outlined. I understand the place from where that person made that statement.
But on my cancer journey, I have met many women who never smoked, rarely drank, ate mostly healthy food, were physically active, and did not have a family history of breast cancer — only to get breast cancer anyway! Many of them had the same type of cancer as me, called “triple positive.” (Hormone positive and HER2-positive.)
I know so many women under 50 years old – and some under 40 – who discovered their cancer by feeling a lump in their breast. By the time you can feel a lump, chemotherapy and other heavy drugs are likely to be a part of your treatment plan; your chances for recurrence could be increased; your chances for survival could be decreased.
Triple-positive tumors as small as mine are not common. Usually, that kind of tumor grows so fast it’s ten times as large, or larger, when discovered. Enough research showed the damage from chemotherapy and trastazumab (Herceptin) outweighed potential benefit for a tumor as small as mine with no detected nodal or lymphatic involvement. So I skipped chemo and Herceptin after surgery. (For more information on triple positive, tiny tumors, see my other website here.)
I am on tamoxifen – a common drug used to lower the risk of hormone-positive breast cancer. I have daily internal debates about this drug. I weigh intense, unpleasant side effects against my recurrence reduction risk. Tamoxifen has a role in my doctor’s appointment today here in Bangkok. But that’s another story for another day.
No one wants to get breast cancer. But if you draw the short straw, you will have more treatment options and better chances of survival if it is detected as early as possible. Even though 3D imaging cannot see everything, it often sees more than traditional X-ray mammograms.
Unbelievably, not all states and insurances cover all costs of 3D mammograms and stereotactic biopsies. Find a way to get it done if you are not covered. Demand these tests. Let my early detection story raise your awareness, and inspire you into action.
Hopefully I can leave all of this breast cancer business behind me in the new Year of the Pig. I happen to have been born in a Pig year, and Chinese astrologers say it will be a lucky, successful year for us Earth piggies.
(Note: I was diagnosed with DCIS while in a foreign country during our early retired budget travel tour. Read about that experience here. I had a double mastectomy abroad, with no health insurance. Read about that experience here. I decided against breast reconstruction. Read my reasons here.)