Tuesday, April 18, 2023

Get your screenings, friends

"Hey, did you hear back about your mammogram yet?" my husband asked me. It was mid-February, the height of New Zealand summer, and we were having a spaghetti date night at long-time Wanaka icon The Cow.  (You might think a restaurant named The Cow would be all about steaks, instead of featuring only spaghetti and pizza. But no, the name comes from the original Queenstown location being built in a stone barn. The menu may be limited, but the spaghetti is pretty darn tasty.) 

"Nah. They'll text me if the results are clear. Last time it took a week or two." Even as I spoke, a niggling thought popped up. Hadn't it already been two weeks since my mammogram? Was it a bad sign if I hadn't heard anything yet? Well, but I'd heard everywhere was short-staffed since the height of the pandemic. Probably the screening people were just backlogged. With that, I dismissed worry. Our conversation moved to other, more fun topics.

But a few days later, when I got a call from a kind-voiced woman explaining that she was a nurse calling from BreastScreen Otago, my stomach sank. 

"Your mammogram picked up a small area of concern," she said. "A cluster of tiny calcifications. The cause could be benign, but we'll need to call you back in for further imaging."

I'd been called back once before, on my very first mammogram, back when I was living in the US. "Your breast tissue is very dense," was what they had said back then. "That's common in younger women, but it makes it hard to identify problems. We need to do some more imaging."

That call had come right after I'd buckled my toddler into his car seat, after a fun morning at a museum in Denver playing with a bunch of cool hands-on science exhibits. When I hung up and slid into the driver's seat, I looked in the rear view mirror to see my son already tilted against the side of his car seat, fast asleep. At the sight of his small face, a pang of visceral terror hit me. A friend of mine had recently been diagnosed with early-stage breast cancer off her very first mammogram. My own first mammogram was earlier than normal, because my mother had breast cancer in middle age.  She'd survived, but only after several painful and difficult rounds of chemo.

Please, no, was all I could think. Not while my son is so young. 

That time, I was fortunate. My further imaging came back clean. I continued to have yearly mammograms in the US, which then shifted to every other year after we moved to New Zealand, since that's the standard interval here for the free breast screening program. 

I'd never been called back again. Until now. And nobody had talked about calcifications before. I pored over the information sheet the nurse emailed to me. Calcifications are common, it said. Most aren't due to cancer. When breast cancer cells are detected because of micro-calcification, they tend to be either ductal carcinoma in situ (DCIS) – pre-invasive cancerous changes in the milk ducts of the breast – or small early breast cancers that have not yet spread.

Hanging up this time, I didn't feel terror. Only a kind of heavy resignation. My mother had been diagnosed when she was only a couple years older than I am now. But her cancer was not caught that early. Driving to Queenstown for my imaging appointment, I clung to the idea of "early" and "small." 

That proved true. After further imaging, a stereotactic biopsy, and an MRI, I've been diagnosed with DCIS, a.k.a. "stage 0" not-yet-invasive cancer. Baby cancer, the doctors tell me. Cancer on easy mode. 98% survival rate. No chemo needed, just excision surgery and perhaps a course of radiation. Assuming we don't identify any lurking invasive component when we analyze the tissue removed in your surgery. 

Assuming is a word that leaves a lot of room for worry. Uncertainty is always a challenge to handle, at least for an engineer like me. At least I won't have long to wait for answers. My excision surgery is tomorrow. If you're reading this, cross your fingers for me. 

And get your screenings. One of the reasons I decided to talk about this publicly was because it's helped me so much to know about friends who went through the same experience. 1 in 8 women will be diagnosed sometime during their life, the statistics say. In New Zealand alone, 9 women are diagnosed every day. And the ages are skewing younger. Both my doctor in the US and my doctor here in New Zealand mentioned that they're seeing far more breast cancer in 40s and even 30s, compared to when they began their practice. Perhaps due to better screening, perhaps due to something environmental, but the point is--don't put off that mammogram or ultrasound. If your mother or other female relatives had breast cancer, ask for screenings starting 10 years before their age of diagnosis, rather than waiting for the official age recommendation. The earlier an abnormality is found, the easier the treatment.  

1 comment:

  1. Thanks for sharing this, and hope the surgery went well. My mother, too, had breast cancer, with all that weight and worry. Screenings are so important, and it sounds like you've been taking every step you can to keep safe.