October is National Breast Cancer Awareness Month.
Breast cancer is the most commonly diagnosed cancer in women. 1 in 8 women will be diagnosed with breast cancer in their lifetime. This disease will unfortunately affect each and every one of us, whether personally or through the experience of friends and/or family.
Although breast cancer is the second leading cause of cancer death in women, survival rates have increased over the past few decades due to better screening, early detection, increased awareness, and improving treatment options. Over 2.8 million breast cancer survivors are alive in the US today.
Routine breast screening is important for all women. Talk with your health care provider about your risk for breast cancer and the best screening plan for you. The American Cancer Society, National Comprehensive Cancer Network, and the U.S. Preventive Services Task Force all recommend informed decision making for screening mammogram starting at age 40, for women at average risk. Women at higher risk (which may include those with BRCA1 or BRCA2 mutation, strong family history, personal history of breast cancer or carcinoma-in-situ, radiation treatment to the chest area, etc). have different screening guidelines and should talk to their health care provider.
Below is a reflection on breast cancer survivorship from friend and fellow physician, Dr. Ana Beeson. Thank you so much for sharing with us.
Medical school prepared me for many challenges, however a life-threatening diagnosis of my own was not intended to be one of them. In March of my final year of med school I was anticipating graduation, earning my long-awaiting “M.D.” and transitioning to internship. The years before had been a frenzy of lectures, exams, hand-on experience on the hospital wards. I was excited to be embarking on a long-held ambition of becoming a doctor and was eager to begin the next phase of my training.
It was early February when I first noticed the lump in my left breast. It seemed like a golf ball had been placed under the skin. I rationalized to myself “must be just a cyst” because healthy 27 year-olds don’t have tumors. I focused my efforts on an upcoming surgical mission to Africa and didn’t give the lump much thought. A few weeks later, after returning from the trip when I realized it was still there – just as firm and alien as it had been before so I scheduled an appointment with my Ob-Gyn. He assured me, “It’s probably just a cyst” and scheduled me for an ultrasound “just to check”. The appointment for ultrasound was three weeks away but I protested to the scheduler that with “Match Day” coming up I wanted this issue figured out before then so I could move on with my life. Enlisting the help of the student health services my appointment was a few days later. Though 8 years have since passed, I remember the look on the technicians face as she passed the cold probe over my chest and the reserved tone she used when she told me she would be back. I was quickly ushered to another room for a mammogram and then the radiologist then performed a biopsy. Two days later the words “Infiltrating ductal carcinoma” appeared and I let out a scream.
Sharing the news of my diagnosis was a challenge. My then-boyfriend (now husband of 7 years) met me at the hospital the night of my diagnosis, we debriefed on our usual Friday-night tradition of sushi and a walk through rainy New York City streets home. He would become the steely pillar of strength through the challenges of treatment and beyond. Unbeknownst to me, news of my diagnosis led him to postpone his proposal plans. I enlisted the help of my aunt (who had painfully lost her own mother to breast cancer) in sharing the news with my parents who were at my side as soon as they could be. Disseminating the news further swiftly became emotionally-draining and I began a blog to share updates but also for the cathartic experience of writing about my experiences.
The next phase was a blur of scans, appointments, and second-opinions and within 8 days of diagnosis I was wheeled into the operating room for a mastectomy and lymph node dissection. I had a short reprieve to heal before undergoing fertility-preservation (egg-harvesting) and starting chemotherapy. I went on leave from school and underwent four grueling months of chemotherapy. A network of friends banded together to help keep my spirits up during the long hours in the chemo suite and beyond. I joined a support group where I was able to discuss the physical, personal and emotional consequences of diagnosis and treatment with women going through the same things. I formed friendships there that last to this day. My daily routine, no longer that of a student, was held together by a rescue dog who, come rain or shine, or neuropathy, or nausea needed to be walked twice a day. She took me on 5am strolls through the park and curled up by my side when I moaned in pain.
A year of surgery, chemotherapy, and radiation passed and I began to regain stamina. I finally received my diploma and joined a newly graduated class of doctors in starting residency. The physical aspects of treatment behind me, this time also coincided with a whole new phase of “survivorship” for me with all of its ensuing uncertainty, disorientation, and fear. I did all that I could do - I just kept going. Soon enough I was immersed in the avalanche of learning, difficult hours, and overnight call. Keeping busy kept me from thinking of the scary “what If’s”. One year became two, then three, then four … and I find myself now approaching 9 years from diagnosis with a full, busy life, a husband and daughter and a career that I love. Was it easy? Never. And I know very well how things could have worked out very differently. I am grateful for every moment I have.
Dr. A. Ana Beeson was raised in NY and Surrey, England. She is now living in Boston, MA and is an Assistant Professor of Neurology at Boston University School of Medicine and Attending Neurointensivist at Boston Medical Center. Mom, Wife, Sister, Daughter.