Friday, March 28, 2008

Breast Assured

I wish I didn't have to write about this, but I feel compelled to reach as many people as I can on this subject. With this Blog, I am first, publicly outing myself as a hereditary breast cancer survivor. It's not that I felt any shame, just a strong sense of privacy. I know this is the first time many who know me are hearing about it. I am definitely one of the lucky ones...13 years and counting (knock wood, spit, spit, pinch pinch) but make no mistake, I am one of the smart ones as well.

The issue I would like to address is "watching it". I don't understand it. What pray tell are they watching??? I have heard too many painful stories of the "it" turning into cancer. Just yesterday, a woman I know of was diagnosed with a 5cm., stage 3 tumor, with much lymph node involvement. A wife. A daughter. A sister. A mother of 3. They were "watching" this mass for two years. At one point she had a core needle biopsy that revealed benign cells. They now believe she was misdiagnosed and she will begin the battle for her young life.

I too had a lump. Not one to muck around, I immediately went to a brilliant, well recommended breast surgeon. Naturally, I was hoping it was a simple cyst, as was he. First step, was a fine needle aspiration. I was thinking, "pop" and I am out of here. No such luck, a solid mass, but the cells that could be extracted were benign. Not hugely concerned, but always conservative, the breast surgeon strongly advised a surgical biopsy. He just didn't feel good about leaving a solid mass in my body and I was in full agreement. Well thank God for his wisdom and my instincts, because lo and behold, it was a stage one malignancy. (The toughest call I had to make was to my Mom, many hours after she had expected to hear from me. I gave her the news and she replied, "well...I am so glad it is stage one and out of your body", "I am going to hang up now, and go have a nervous breakdown"...even in the worst of times, we find our laughs).

So, while I am not offering medical advice, I will offer some common sense information, for you to consider and pass along:

* Do a monthly breast self exam. At the very least, be in touch in the shower daily. (I can't be sure how long I missed my own lump, because at the time I used a shower sponge)

* Have a digital mammography annually, preferably at a facility where a radiologist will perform a thorough manual exam, afterwards

* If your breasts are dense, get a prescription for an ultra sound to be performed after your digital mammography

* If you or your Dr. find a lump, it may be a simple cyst, but please don't take chances. Explain the situation to the facility that does your mammograms. You will be seen and tested as a priority. Don't panic and do not ignore it. It is not going away, no matter how hard you wish for it

* If you are at high risk for breast cancer due to family history, speak with a Certified Genetics Counselor to assess your risk and possible testing for genetic mutations. You can inherit a mutation from your mother or father, so don't dismiss cancer history on your paternal side. It is also prudent to be under the care of a breast surgeon, who may prescribe an MRI, instead of digital mammography and ultra sound.

* If you do get a phone call or letter telling you that they have found something that needs further investigation, try not to panic. Most breast lumps are benign, but you must follow up asap. Core needle biopsies are often recommended, as it is a less invasive procedure than a surgical biopsy. When performed by a top notch breast specialist, it is quite reliable (often done in conjunction with scans)

My words of caution are to those of you, who are then told you have a mass that they are going to "watch". Get a second opinion. Listen to your gut. Be smart. Be proactive. Be here.

xox,
Dd

8 comments:

  1. Beautiful job, Diva Deb.
    As physician and a "previvor" (prophylactic mastectomies to avoid breast cancer), I could not agree more with your post. It is imperative for women to be vigilant and proactive with their bodies.
    We can all take control of our health and beauty.
    E

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  2. You must have a guardian angel....how lucky you were to have a great doctor from the beginning!!

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  3. Debs you're a real trooper to share this information with your bloggers. I know how you value your privacy. You did your girls a real service here. Love you, Sis.

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  4. Thanks so much Elizabeth. I know how much you know, and appreciate your support and friendship.

    Suzanne, a great Dr. indeed, your Dr.(Andrew)Ashikari's father, Roy!

    Sis,
    You will never know how truly thrilled I am that you dodged the bullet on the family cancer curse...wouldn't it be great if the buck stops with me?

    xox,
    Debbi

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  5. Dearest Deb, Your message is sage, sane, kind and generous. Have recently been educated about rectal cancer because a very close friend diagnosed with disease. The lengthy operation was successful and she is free of cancer. She has always been diligent about breast exams because breast cancer runs in her family. Your words are very poignant in that "one must listen and pay attention to your body"!! It can be your savior. Many thanks for sharing and for your honesty. Love, Liza

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  6. Oh Liza!
    You are so dear! I am so happy things turned out well for your friend. I am so thankful when I hear the "good" cancer stories.
    In addition to listening to our bodies and trusting our instincts, we must do follow up, particularly in familial high risk situations. Another friend was 2 years past her colonoscopy and had a very large malignant tumor. Miraculously, though her Drs. anticipated a stage 4 pathology,
    the pre surgical chemo was very effective and it was determined to be stage 1!

    xox,
    Dd

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  7. Debbi...YOUR openess will do so much for those who need to hear it!
    I shall never be able to repay you with the kindness you showed me during my prophylactic surgery...how wonderful it was to be wheeled back from recovery room and hear your voice at the other end of the phone...and I had never even met you! Imagine what everyone is going to learn from you and your gorgeousness in this blog...if they only manufactured a product to get a beautiful heart as yours is...perhaps these beauty products REALLY get absorbed???
    Love you for life! MAL

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  8. Mal Darling,
    You have repaid me a thousand times over by being an amazinging friend...How lucky am I???
    When we stretch ourselves, great things happen, as long as they are not expected. You are one such gift.

    xox,
    Debbi

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