S. E. Williams
This month we take time to honor the women around us who came face to face with breast cancer and weathered the storm, while we simultaneously extend support for those still waging the fight of their lives.
The prevalence of breast cancer is breathtaking—one in eight women will be diagnosed with breast cancer in their lifetime. And, when America entered the new year on January 1, 2021, still reeling from the impacts of COVID-19, there were more than 3.8 million women with a history of breast cancer in this country, while more than 330,000 women were projected to be diagnosed with new cases of breast cancer throughout the year. Breast cancer remains the most diagnosed cancer in women.
Behind every one of those 3.8 million women who already experienced or were experiencing breast cancer when we entered 2021, and behind the additional 330,000 additional women being added to the breast cancer roll this year, there is a story of suffering, courage, strength, bravery, and in most cases, survival.
Many breast cancer survivors are willing to share their stories to help raise awareness, to encourage women not to leave their health to chance, and to make people aware of how breast cancer can manifest in many ways.
Also, just as it is important to know the risk for breast cancer is almost double for any woman whose mother, sister, and/or daughter was diagnosed with breast cancer, it is equally important to understand that nearly 85% of breast cancers are diagnosed in women with no family history of it.
When we least expect it
It was after dinner on Thanksgiving eve 2012, when Sandra received an unexpected call from her primary care physician with disturbing news about the results from her recent mammogram—the doctor suspected cancer in her right breast.
The cancer diagnosis was like a bolt out of the blue for her, she explained, after all, there was no history of breast cancer in her family.
The next two weeks were a blur of appointments, tests, more scans, and biopsies, she recalls. When the oncologist sat her down and pointed to the problem on images of her right breast, Sandra said it looked as if someone had sprinkled granules of salt on both sides of it—‘calcification’—the doctor advised, and it was cancerous (ductal carcinoma in situ or DCIS).
The options were not good—either carve out large sections from both sides of her breast or opt for a mastectomy—she chose the latter. Despite this choice Sandra said she feels lucky—her cancer was caught early, her follow up treatment was successful and nine years later she remains cancer free.
Before being diagnosed with breast cancer, Sandra said she was always very diligent about her annual mammograms and remains so today. This is something she stresses when telling her story to others. She also emphasizes two additional points. First, that there was no history of breast cancer in her family and second, even though she routinely does self-breast exams, there was no lump, no breast discomfort of any kind—nothing that would have tipped her off to the cancer growing in her breast. She advises had she not also been diligent about her annual mammograms, her breast cancer may have gone undetected until it was too late.
Everything was going right, until something went terribly wrong
Among women 45 years of age and younger, the incidence of breast cancer is higher among Black women than White women.
Rachel, an African American, was in her late 30s when she received her breast cancer diagnosis in 2019. After eight years of marriage during which she and her husband earned advanced degrees, traveled the world, secured the jobs of their dreams, bought a home and were now the parents of young daughters, two- and three-years of age. It seemed everything was going their way—until the morning Rachel awakened with a discomfort in her left breast.
Rachel had stopped breast feeding her youngest a few months earlier, so she decided to check with her gynecologist out of an abundance of caution. She would ultimately be diagnosed with Stage 1 ER Positive, Ductal carcinoma.
She opted for a lumpectomy which was followed shortly after with radiation. After completing a series of radiation treatments Rachel began a 5-year course of Tamoxifen, and this year, started monthly injections of Zoladex to stop her menstrual cycle and limit/stop the production of estrogen. Due to her age and because her cancer feeds on estrogen the oncologist recommended Zoladex injections to decrease chances of the cancer’s recurrence by another two to three percent.
When Rachel was initially diagnosed, she had two fears. First, that she might carry the BRCA gene and maybe passed it unknowingly had passed it on to her baby daughters along with its increased risk for breast cancer. She took a DNA test and was relieved to learn she does not. Secondly, she worries the cancer will reoccur and she will not be here for her young daughters as they grow to adulthood. It was this fear that propelled her to opt for the Zoladex injections to gain that very slight, additional edge against the cancer returning.
She is now experiencing the symptoms of menopause—including hot flashes, etc. but said it is worth it for the added chance of being here for her girls.
Although breast cancer impacts all women, research confirms Black women are at greater risk of dying from it. Over the past 20 years, despite the universal decline in breast cancer mortality rates, the mortality rate among Black women with breast cancer remains high and is the highest among all other ethnic groups.
Joining the fight against breast cancer
The best thing we can do for ourselves is to know our family history. It is also important to remind women nearing the age of 40 years that turning 40 marks another of those important passages in a woman’s life—like her first menstruation as a maiden and her last menstruation as a crone–40 is when women should begin their annual treks to radiology for those all-important mammograms.
If you have dense breast tissue insist on an ultrasound. If you are unsure of whether your breast tissue is dense, ask your primary physician or the radiologist who does your mammogram. This is important because there are some breast cancer indicators that do not show on regular mammograms when your breast tissue is dense.
It is also important to examine your breast each month. It is recommended you do so within four to five days of the onset of your period. It is also recommended that you examine your breasts the same time each month.
There was a time—not too long ago—when we did not speak of breast cancer out loud, and as with so many other things, we have learned that “silence equals death.” We must continue to tell the stories of women like Sandra, Rachel, and others willing to tell their stories so we can learn from their experiences. Mothers are encouraged to teach their daughters. Sisters should encourage their sisters and friends. encourage friends to check their breast, keep up with their annual mammograms and if something about their breasts does not feel right—check with their primary care physician.
This is important because although Black women are at higher risk for breast cancer means early detection can save lives.
The fight against breast cancer is not someone else’s to fight on our behalf—we must all do our part.
Of course, this is just my opinion. I’m keeping it real.