Sometimes, You Need More Than Just a Mammogram
It is mind boggling that 1 in 8 women will be diagnosed with breast cancer in their lifetime. By the time you turn 40 years of age, you should be on your toes about getting a mammogram each year. If you have an insurance plan, it should be covered. If not, there are many clinics that offer free screenings.
Mammograms are the best breast cancer screening tests we have at this time. However, mammograms have their limitations. For example, they aren’t 100% accurate in showing if a woman has breast cancer. They can miss some cancers, and sometimes they find things that turn out not to be cancer (but that still need further testing to be sure).
Cancer runs in my family. My mom was diagnosed with Stage 4 lung cancer at the age of 72 in otherwise wonderful shape, living her best life. She was not a smoker. There were so many why’s. We lost her recently, over a two-year battle recently and my heart is broken. My grandmother lived until 99. She was not diagnosed with breast cancer until the final year of her life. Her mother, however, died in her 50’s, of cervical cancer.
Yoga Pose
This past September, I was diagnosed with Stage 2, Her 2 positive breast cancer, it was a real shock. Personally, I am in very good shape. I have ran 5 marathons, played competitive golf, am certified to teach yoga, practice regularly, hike weekly and am constantly trying a new workout. Fitness and wellness, is a big thread in my life. For the most part, I eat super healthy, but I work hard and play hard and yes, I like my wine.
Being the type of person, who wants to get to the bottom of everything, I put everything into learning, the same way I did, when looking after my mother. What more could I do? How could I change my diet? What went wrong? I had just got a mammogram in February in Beverly Hills, that was clean. My “Happy Gram” report that I received stated that my mammogram was “NORMAL” and that there were “no significant findings.” However, I didn’t read the fine print, that I had dense breasts. Most of us don’t read the fine print, but we should and should question. Dense breasts can obscure findings on routine mammography making cancer more difficult to see.
Women with dense breasts (2/3 of pre-menopausal and 1/4 of post menopausal) have less than a 48% chance of having breast cancer detected by a mammogram.
Overall, screening mammograms miss about 1 in 8 breast cancers. Women with dense breasts are more likely to get false-negative results. What are dense breasts? Breast density is a measure of how much fibrous and glandular tissue there is in your breast, as compared to fat tissue. It isn’t related to breast size or firmness. False-negative mammograms can give women a false sense of security, thinking that they don’t have breast cancer, when in fact they do.
In many states, women whose mammograms show heterogeneously dense or extremely dense breasts (which includes about half of all women) must be told that they have dense breasts in the summary of the mammogram report that is sent to patients (sometimes called the lay summary).
Working while in treatment.
The language used is mandated by each law, and may say something like this:
“Your mammogram shows that your breast tissue is dense. Dense breast tissue is common and is not abnormal. However, dense breast tissue can make it harder to evaluate the results of your mammogram and may also be associated with an increased risk of breast cancer. This information about the results of your mammogram is given to you so you will be informed when you talk with your doctor. Together, you can decide which screening options are right for you. A report of your results was sent to your primary physician.”
Don’t ignore it, yet evaluate carefully. Additional tests such as a diagnostic mammogram or breast ultrasound or MRI of the breast, may be needed to look more closely at the area where you’re having symptoms. Often, this is an out of pocket expense of a couple hundred dollars or more, but worth it.
3D mammography can find some cancers not seen on regular (2D) mammograms. Some studies have suggested 3D mammography might be particularly helpful in women with dense breasts. It can be used as a screening test along with or instead of standard mammography, although it isn’t yet available at all imaging centers. Most importantly, women should discuss their mammogram findings with their doctor, and understand if more imaging is needed.
Six major studies with over 42,000 women concluded that by supplementing a mammogram with an ultrasound increases detection from 48% to 97% for women with dense tissue. I also learned that women with extremely dense tissue are 5 times more likely to have breast cancer when compared with women with fatty breasts.
In addition to taking these extra steps, genetics is something to be looked at. Invitae offers genetic screening tests, that you can pay for out of pocket. The tests look at hundreds of genes, looking at your DNA, showing your risk rate of disease. You can take this anytime, but it is especially important when diagnosed with Cancer. For instance, do you have the BRCA gene? Knowing what you are predisposed to, can help guide you and your doctor to the most effective treatments, bringing you one step closer to beating cancer and then staying healthy in the long term.
Early-stage Her 2 positive breast cancer often requires a year of therapy, and more advanced care treatments are continuous. Cancers that express Her 2 tend to be more aggressive. They grow faster. Hormone driven breast cancers are the most common type, affecting nearly ¾ of women diagnosed. This is why finding out the genetics are important. In many cases, a person’s genetics has made them more susceptible to cancer—and, as a result, they may respond differently to therapies, benefit from more aggressive treatment, or take action to avoid getting cancer again in the future.
Ringing the bell after treatment concluded.
My treatment started in September and continues at Texas Oncology. The care has been phenomenal. It started with 6 rounds of chemotherapy, followed by surgery. It was challenging, but rarely took off work. In fact, the work momentum was helpful. This month, I complete radiation, then continue with ongoing infusions for 7 months and hormone blockers for five years. My outcome from treatment and outlook is very good.
While we may wonder about the past, we can only move forward. Advances in medicine and treatment are evolving. Equally important throughout this process (not only for prevention, but during treatment and healing) is integrative nutrition and exercise. A holistic approach alongside conventional medicine is important for cancer support.
This publication is mostly east coast readers, thus am providing outposts in the region for treating breast cancer. In no particular order, the top places are Sloan-Kettering, Penn, John Hopkins and Dana Farber. Breast Cancer Resource Center (BCRC), has been a tremendous resource for me. This is a professional organization providing direct assistance and breaking down barriers to treatment, staffed by breast cancer survivors. Finding a regional or local organization where you can bounce ideas off other patients and survivors, not just doctors, gives you a broader perspective and support network.
The Susan G. Komen Foundation is an excellent source of information on breast cancer and finding out where to get screenings nationally.
If you are a caregiver, the little things mean a lot. Help them by driving them to appointments. Sit with them during chemotherapy. Prepare small meals – vegetable and fruit heavy, as the body is not able to tolerate the usual. Make sure they are hydrated – water, coconut water, low to no sugar electrolytes. Watch a movie with them, read books with them and get them out for a walk. While rest is important, distraction and movement is key. Above all, circle them with faith.
Sources: American Cancer Society, AreyouDense.org, WebMD magazine, Texas Oncology.
Top photo: Nichole Wright with her mother, Mary Lynn Wright
All photos courtesy of Nichole Wright