Fatalism and Lucky Charms

When I was 17, a month or so after my mom died, I went to see her oncologist. He was a personable man in his early 40s with kind blue eyes. I told him that I was scared of getting breast cancer. I talked to him about my increased risk as the daughter of a woman who was diagnosed with pre-menopausal breast cancer. To help allay my fears, he scheduled me for a mammogram. I'm sure he knew that performing a mammogram on a 17 year old was pointless, but he did it to make a scared, confused motherless teenager feel better.

I went to the radiology lab for that mammogram and I remember first being surprised that my mom's doctor wasn't there to perform the procedure. As the radiology techs set me up and took the x-rays from several different sides and views, a hot clammy warmth washed over me. My mom had been through this same procedure so many times in the almost three years that she was sick. I couldn't help but think of her and what she must have gone through.  In addition to that, I was truly, irrationally and completely terrified that I might have breast cancer.

After the results of the mammogram came back, the only thing that was noted was a fibrocystic breast condition. Basically this means that the breast tissue is extremely dense and contains a lot of fibrous tissue that makes the breast feel lumpy. This makes it harder to detect tumors through self examination. My mom had the  same condition. This did little to calm my fears.

I went through my early 20s in kind of fog, trying not to think about breast cancer. I did not have another mammogram until 10 years had passed. I couldn't do self examinations in anything more than a cursory way because I would get physically ill. That same hot, clammy feeling would wash over me and I would feel a strange uneasiness in the pit of my stomach. There was always a sense of apprehension that I would someday get breast cancer. It was never a matter of If for me; but When. I felt as if my breasts were two loaded guns pointed at my chest.

I somehow learned that there was a female professor on my campus who was a breast cancer awareness lobbyist and advocate. I made an appointment to go and talk to her about what I was feeling. She shared that her mother and two of her sisters had been diagnosed with breast cancer and she knew exactly what I was feeling.

It was such a relief to hear my feelings, if not the actuality of my fears, validated by someone who had experienced the same things I had. This was at the time when genetic testing for the BRACI and BRACII genes had just come to the forefront. She said that she had not been tested because she didn't feel there was a point. If a woman is negative for the gene, she could still develop breast cancer and the presence of the genes does not indicate a 100% chance of a diagnosis. Additionally, insurance companies at that time were using the genetic test as a way to disqualify a woman who had  the gene and later contracted breast cancer. Declaring it as a pre-existing condition for women who were positive for the gene, they could deny coverage for hospitalization and treatment.

This woman, who was in her mid 40s had opted for prophylactic mastectomy of both her breasts. In essence, she had both of her breasts and all of the tissue surgically removed and reconstructed. This concept may seem extreme to some people; electively removing healthy breast tissue. To me it made perfect sense. The pain and trauma of the surgeries and recovery process is nothing in comparison to the dark, sucking abysmal fear that you would one day get breast cancer and have to suffer in the way you saw a loved one suffer. I decided then and there that this would be an option I would keep and consider when I was her age.  I have not been tested for the breast cancer gene. I don't think it would make me feel differently to know one way or the other and the political/legal implications of pre-existing genetic conditions are still being decided.

Because I had so much trouble doing self examinations and because of my fibrocystic condition I convinced my primary care physician and my insurance company that mammograms were medically necessary at the age of 28, considering my family history. It took me a few months and a lot of phone calls, paperwork and red tape, but I finally did it. When I got the mammogram, they found abnormalities in my left breast. I had to return for a second, more precise x-ray that magnified the problem area. My friend Caroline went with me and kept me company. I was so glad she was there. In the past I have had a hard time holding it together on mammogram days.

The diagnosis came back as microcalicifcations, not malignant and not necessarily a precursor or indicator of cancer. They told me that I would need to be monitored closely for changes over the next two years. I would need to return for mammography every six months. The words of that diagnosis, especially the word "necessarily" were difficult for me to deal with. I spent the next two years not thinking about it and still unable to do self exams. I would put it out of my mind until a week or two before my mammogram. Each time things looked the same, which was the best I could hope for. At that point I went back to yearly mammography.

Two years ago my mammogram showed that the calcifications had grown and changed and I was ordered in for a stereotactic biopsy. This is a surgical procedure where core  tissue samples are removed. During the biopsy, eight calcifications were removed from my left breast and all were non malignant. The doctor placed a tiny metal disc in the area where the calcifications had been so that in future mammograms they will know where to look for irregularities.

Throughout all of these experiences, I have been calmly resigned. As I get closer to 38, the age at which my mom was diagnosed, I feel more and more fatalistic. Up to this point, all results have been positive, even if the process has been enough to drive me crazy. Yet somehow if I were to be diagnosed with a malignancy, I don't think I would be surprised. Strangely it might even be a relief to not have to worry about it anymore.

I truly believe in the power of mind over matter. I know that the mind can heal the body. I should be thinking positively about all of this, yet deep inside me I cant help believing that I may get breast cancer someday.  When I look in the mirror and see similarites to my mother in my body type and my physical appearance, it scares me. I don't want to feel this way, but I don't know how not to.

So I try to focus on the positve within the negative. I am being as proactive as I can about early detection. If I were to get breast cancer, the treatment technology is much more advanced than it was 20 years ago and the survival rate is much higher.

Jeff's mother is a breast cancer survivor. She is one of the most positive people I know. When we've talked about her illness before she had never once expresed that she stopped fighting it or ever thought it was going to beat her. And she won. In some superstitious, irrational way, she is like a talisman to me. If she beat it, then so will I. And I have Jeff. I know that no matter what happens he will be next to me. He will have the strength and love and positivity to get both of us through to the other side. He has already done so much to make me more whole.

Tomorrow I have my yearly mammogram. As in the past years, there is a small creeping fear in the back of my mind, but I will do what I always do. I will go and be pressed and flattened and smashed and squashed up and down and all around. It will be uncomforable physically because, damn, your boobs are not meant to be flat as a pancake.  And you can see it though the glass, all smooshed up. I've already gotten over a total stranger manhandling my breasts, so that part isn't so bad. But the squashing, that's another story. It will be uncomfortable mentally too, but I will try to focus on the positive. I'll tell myself that I'm doing what I can to take care of my body.

I'm writing about it here to do what I can to take care of my spirit as well.

Comments

[Caroline]

I'll be with you tomorrow, T...maybe not there you know what I mean. All good things - much love, C

[schmutzie]

My thoughts are definitely with you. I have cystic fibrous tissue in my breasts as well, and the day of my ultrasound was so scary, so I know a little of your fear. Be well.

[Amy]

I'll have you on my mind tommorrow and I'll be sending good vibes in your direction.

[Lori]

T, I am reading this post late, but very touching. I am so glad everything is ok. :)

[chris]

I too had my Mum and sister die of breast cancer and now a mammagram has shown microcalcifications in my own breasts- I had a biopsy and I am going today to get the results - so I'm in a bit of a state to say the least - it's comforting to know others share my feelings.