For a week in October, I had breast cancer. But maybe I should start at the beginning.

In September I got my usual mammogram and was called back for more images, which had happened before so I wasn’t worried. But this time, the radiologist saw something and recommended a biopsy. An ultrasound-guided core biopsy was done September 30; I love to know how things work, so the best part for me was watching the procedure on ultrasound. The worst part was the dozen or so mammograms done just before the biopsy to pinpoint the tumor’s location. These were done on a mammogram machine that produces more detailed images, but the most interesting part of that was the machine’s pressure read-out. Almost 30 pounds, ladies: stack three 10-pound bags of sugar on your—well, let’s move on.

The following Monday, we got the results: it was cancer, an invasive ductal carcinoma. Friday we saw the surgeon who recommended breast-sparing surgery, commonly called a lumpectomy. She said, “I’ve got a cancellation Monday,” and I said, “I’ll take it!” I lived with the knowledge that I had cancer only from Monday October 6 to Monday the 13th, just a week, and then it was gone. What’s amazing is that something that sounds so major can be accomplished with outpatient surgery; I was at the hospital only a few hours and then home. The pain was minimal.

I was lucky in many ways: the tumor was small, only 0.9 centimeters (about the size of a frozen pea), and slow growing; it was minimally invasive, just starting to breach the duct walls. It was also estrogen-positive, which means I have a good chance of heading off recurrences by taking Femara, an estrogen-blocking medication; years ago, my mother was part of a clinical trial for Femara and took it for five years after her lumpectomy, so I have no qualms about taking it as well. The pathology report showed that the margins were clear—doctor-speak for “We got it all!” In addition, my cancer was in my right breast, which kept the radiation farther away from my heart, and that’s a plus.

Next step: radiation. I was fortunate to qualify for hypofractionated radiation therapy as has been in the news recently and in Chet’s Tuesday message; it’s a shorter course of higher doses resulting in less overall radiation. My radiation oncologist recommended 16 general breast radiation treatments, followed by seven more-concentrated treatments. I asked him if radiation improved the survival rate, and he said, “Not really, but it’s been shown to reduce recurrence of cancer.” Good enough for me; I’d rather go through the radiation regimen than worry about whether any of the little varmints escaped and were setting up shop elsewhere. Radiation started mid-November and was done before Christmas. The treatments themselves are quick—in the room and out again in 15 minutes or less—and even though I felt fine all through the process, it’s an every-day schedule, Monday through Friday, so it gets wearing after a few weeks. I pushed my way through the schedule and only after it was done did I realize how exhausted I was; much napping ensued.

There are three reasons I’m telling you my story. First, I want you to know that if you’re going through breast cancer treatment, you know one more person who made it through just fine, and odds are you will, too.

The second is to remind you to do your monthly self exams. Since my tumor was in the back of my breast, I never felt it, but many women find their tumors themselves. And if your significant other wants to help, that’s good, too; a small but significant number of tumors are found by husbands, so let’s take all the help we can get.

Third, I want to encourage you to get your mammograms regularly and on time so if anything goes wrong you catch it early—for several reasons:

• You’ll want the tumor to be tiny so the whole process will be as small and fast as possible—shorter, less complicated surgery, less radiation, and so on, but the best reason is to avoid chemotherapy, which takes a much greater toll than radiation. Luckily I didn’t need chemotherapy.
• The larger the tumor, the more tissue is removed, and thus the larger the divot in your breast; mine was close to the chest wall and small enough to blend in without leaving a noticeable dent. It also left a relatively small scar; very low necklines are out, but I don’t wear them anyway. I hope I don’t seem vain, but appearances matter to women; the less damaged we feel, the better we feel about ourselves.
• You want to minimize the amount of radiation needed because the effect is like a sunburn, and in some areas, a really severe sunburn. Now I know why pink is the color associated with breast cancer: that’s what color your skin is after they’ve zapped it several times. But like a sunburn, it clears up quickly.
• Most important you want to catch it while it’s small enough to be detected but hasn’t spread. According to the information I was given (and there was a lot), 100 days is the estimated average time it takes for breast cancer cells to double in number; the range is from 23 days to 209. At 100 days to double, it would take nine years to reach 0.5 centimeter, and only one more year to reach 1.0 centimeter. I’m living proof that a tumor can be caught in that interval and eliminated, but I’m glad I didn’t wait another year.

I was also lucky to get treatment by Betty Ford Breast Cancer Services and their associates at Lemmen-Holton Cancer Pavilion in Betty Ford’s hometown of Grand Rapids, and it was phenomenal; the people were especially friendly and helpful, and I’ve never gotten so much information and emotional support for a health issue. Let me add that we all owe an incredible debt to Betty Ford because breast cancer treatment wouldn’t be nearly as advanced as it is now if she hadn’t spoken up: weeks after becoming First Lady, she had a mastectomy for breast cancer on September 28, 1974. Her openness about her cancer and treatment opened a national dialog about a disease that we’d all been reluctant to talk about.

So I’m a breast cancer survivor, and you may be wondering why I’m wearing red, not pink. Here’s why: as much as I appreciate and have benefited from the work of all the women in pink who’ve helped advance the state of breast cancer research and treatment, more women still die of heart disease—so I’ll continue to Go Red because I think that’s where more attention needs to go. When you talk to your doctor about scheduling your mammogram, ask her about a cardiac stress test as well. It’s no more fun than a mammogram, but it’s important for living the best life you can for as long as possible.

Paula

 

P.S. Now for something lighter: check out this link to “An Open Letter to the Mammogram Machine at Beth Israel Hospital” by Amelia Blanquera; all of us who’ve encountered one can appreciate this humorous look at her “relationship” with the machine.