Womens Health: Breast Cancer - One Woman's Story

A few years ago, I received a phone call that took my breath away. It was from the Cross Cancer Institute, a world renown cancer research and treatment center located near the University of Alberta campus in my city. The pleasant-voiced woman on the other end of the line identified herself and her organization to me, checking my name and address was correct, asking what arrangements my doctor had made for my treatment.

After I caught my breath and reclaimed my voice, I heard myself ask in tremulous tones what treatment she was calling about. The woman sympathetically reaffirmed my name, address, health care number, and my doctor's name. She went on to inform me that the results of my latest mammogram had shown a small anomaly, and that I was booked for a further exam at the Cross Clinic the following week.

Hanging up the phone, I realized I couldn't feel my feet. "Don't be silly," I told myself, firmly. "That only happens in novels." Nonetheless, I sat down quite quickly. I told myself there must have been a mistake. Someone must have misread something - this couldn't be happening to me...

Some years before this phone call, a young acquaintance showed me a very pretty beaded key chain. It was a curious construction, with beautifully faceted and hand-carved pink beads graduated from tiny to quite large.

She explained that it represented which process could be used to detect the various the sizes of anomalies in the female breast, ranging from the largest, about the size of a walnut and detectable by breast self exam, BSE, to the smallest seed bead, detectable by regular mammography.

I had been faithfully performing BSE for several years by then, and was shocked to realize the size a lump would have to attain before my fingers would be able to detect it, even with the considerable practice I then had.

My young friend then went on to declare that every woman over the age of twenty should have a yearly mammogram. I flinched involuntarily at the thought, remembering all the flattened-breast joke, and crossing my arms protectively over "the girls". In the end, though, I decided maybe I should at least consider the idea.

It took a while longer for me to actually arrive at a screening clinic. Something always seemed to come up - to deflect my good intentions.

"...and wouldn't you know", I thought. "first time I have a mammogram, they go and find something!" Beginners' luck, I guessed.

Still thinking there must have been a mistake, I presented myself at the Cross Institute the following week. Shortly after trundling down interminable corridors, and stepping across the threshold of the breast clinic, I realized I had been admitted into an incredible sisterhood. The caring and concern shown me was almost overwhelming.

Feeling a bit of a fraud, I hastened to assure anyone who cared to listen that I had not been definitively diagnosed. Nothing had been certified.

Soothing smiles abounded. I was reassured on every hand that nothing was written in stone, and until the doctor had seen me, nothing would be truly known.

My mother died of lymphatic cancer in 1987, my partner's sister had just been diagnosed with chronic lymphocytic leukemia, and my father had recently undergone surgery for prostate cancer. Feeling I had already learned far to much about some of the various forms of the disease, I sat quietly in my comfy chair, waiting for my turn with the doctor while I mentally reviewed everything I had ever heard or read about breast cancer.

Breast cancer used to be a death sentence. The same was, of course, true for most forms of cancer, but breast cancer seemed particularly fearsome because it struck at the very heart of the female psyche. So much of how we were defined as women, how we defined ourselves as women, was bound up in those mammary glands, and still is for some.

After our mother died, one of my sisters and I had discussed what we would do if we were ever diagnosed with different kinds of cancer, and what arrangements we would make for our children.

Radical mastectomy was then considered the only safe method of treatment, followed by chemotherapy and, sometimes, radiation therapy. Reconstructive surgery for breast cancer patients was still in its infancy, but I had already decided that I would seek out a doctor who was willing to perform the less radical procedure to allow for eventual reconstruction. "Plan ahead" was a favorite family motto.

...and now here I was, sitting in a cancer clinic, with thoughts of needle biopsies running through my mind - a needle biopsy is a procedure in which a needle is introduced into the breast tissue, and a small sample is removed for microscopic analysis.

Finally, my name was called and I was shown, trembling ever so slightly, into the change room. After disrobing and trying to cover my shrinking flesh with the regulation, skimpy hospital gown, I was ushered into an examination room crammed with computer equipment, two nurses, a female technician, a male student doctor, and the male doctor who was to carry out the examination.

I was most courteously introduced to everyone and asked if I would mind having a visiting foreign student attend the procedure.

At this point my natural sense of the absurd asserted itself and I gravely assured everyone that I didn't mind at all. "The more the merrier," I assured them, "...anything for the furtherance of medical knowledge!"

Discovering that the doctor who would be carrying out the exam was the head of the breast cancer screening program only served to heighten my growing sense of unreality. Fear of the unknown and my growing stress levels were conspiring against me, combining to make me feel a bit giddy.

I was asked to lie down on the chilly, metal examination table as the doctor and his student seriously applied the ultra sound-like instrument to the mammary gland in question (my left breast). I could feel a bubble of humor welling up inside. While they carefully examined the rather grainy image on the screen, I, too, peered at the breast-scape to see if I could discern an anomaly amid the snow and shadows.

They came up dry, though, and I was asked to sit up. Perhaps they could find it if I was in a more erect posture, they postulated.

We all examined the screen with renewed interest - still a no=show. One of the nurses leaned over and quietly asked if I could see anything, but there was nothing I could add beyond a stifled giggle as the still-cold instrument slid around to the side of my breast for another run across the snow-field.

I regarded my exposed breast, noting its reaction to the cold instrument, and commented that at least, with this metallic encouragement, I could finally almost pass the pencil test. The nurse stifled a smile and made no reply, but the foreign student turned and asked what I meant.

I looked away from the screen and caught the nurse's eye. We bonded instantly, kindred conspirators.

Hard-pressed no to burst out laughing, I explained the test to the young man - that a girl would test the perkiness of her breasts by placing a pencil under one of them. If the pencil fell to the floor, she passed. If, however, the pencil stayed in place, the girl failed the test, and her breasts were not perky. I looked down at my exposed breast, both nurses looked down at my breast, the student doctor looked down at my breast.

The head of the program gazed steadfastly into the screen.

Looking up at each other almost simultaneously, the nurses and I started to giggle. The young doctor blushed.

The head of the program turned to me, asking if I knew where the anomaly was.

"It's about here," I replied, gravely, indicating its approximate position with the fingers of one hand.

After one more try, helped not one tiny bit by the blushing student doctor, and the stifled but nonetheless just-audible giggles of the patient and her attending nurses, the head of the program delivered himself of his considered opinion, collected his student and departed.

I was one of the lucky ones, after all - at least for the time being. The anomaly was small and encapsulated, requiring no immediate treatment, only continued monitoring. I was exempt from full membership in the sisterhood, but relegated to a curious kind of limbo in which I must temporarily rejoin my sisters every year for yet another examination.

Am I grateful they caught this tiny, aberrant piece of my physiology? Yes. Even though it is still cause for some trepidation, every negative exam result is also a cause for celebration. I am now, more than ever, aware of new treatments, new initiatives, new hope for a cure.

Do I continue with my monthly BSE regimen? Yes. It is almost second nature, and though I have never found another anomaly, it comforts me to know that this supports my yearly mammograms.

Can you make a difference? Yes. Tell your family, your relatives; tell every female friend, and every woman you know that they are at risk from this disease, but that there is something we can all do about it. Encourage them to learn and practice breast self examination. Convince them to have regular mammograms.

Get involved in fund-raising efforts in your community.

I remember sitting on the bus shortly after my mother died of cancer, looking up at an advertisement urging us to buy daffodils to support cancer research. at that moment, I was too distraught to believe the slogan, but time and advances in the research that came too late for her have changed my heart. I now believe that cancer can be beaten.

Please do your part.

© 2009, Text by Elle Fredine, All rights reserved