When Did You Get Your First Mammogram? This is My Story…

You won't find this story in you October issue...

You won’t find this story in your October issue…but it will be online.

In its October 2014 issue, Better Homes & Gardens magazine will run a feature in which seven people responded to the question “When did you get your first mammogram?”

My story won’t be among them. will be online. [Kudos to the health editor for picking up the phone and calling me.]

The author, freelancer Camille Noe Pagan, told me my story was cut at the last minute due to space restrictions. Mammograms are generally not as effective as the average woman might suppose. And when it comes to breast cancer, there are 155,000 US people like me who are living with Stage IV breast cancer, the kind for which there is no cure.

This is not a story that fits in the well with the typical Breast Cancer Awareness Month uplifting narratives. (See Dr. Peter Bach’s excellent “Avoiding the Pink Warrior Trap” in New York magazine.)

My first mammogram was also my last mammogram. I am telling my story in the hopes it will educate people and inspire them to talk to their doctors about what would be most appropriate for them. Also, I want people to know about people like me—people who will always be in treatment for breast cancer and, in all likelihood, will ultimately succumb to the disease.

BH&G’s freelancer sent me the following questions and then boiled my written response down to 100 words, which hopefully will be online soon. But here are my original comments.

When did you get your first mammogram?

I got my first mammogram after the July 4th holiday weekend in 2009; I was 43 years old.

Why did you choose that particular time to get started? What did your doctor say, and did his/her advice sway you?

Things were clearly winding down at my publishing job.With my continued employment on shaky ground—as well as the attendant health benefits—I could no longer procrastinate about seeing my doctor.

All was going well with my general physical. But then the nurse practitioner felt a hard spot on my breast. She gave me a prescription for a diagnostic mammogram. I wasn’t too concerned—I felt fine and was tempted to ignore the nurse practitioner’s advice.

She wasn’t an alarmist, but she did stress it was important to follow up and get the mammogram, so I did. A diagnostic mammogram is different from a routine screening mammogram. Anyone who is told to get a diagnostic mammogram should most definitely do so!

What was the experience like? Any surprises? Things you wish you would have done differently?

The test itself wasn’t painful.

The surprise was finding out that day I definitely had breast cancer. (“This is NOT a cyst,” the radiologist told me. “You have to see a surgeon.”)

In preparation for a mastectomy, the surgeon ordered a round of imaging tests (PET/CT, MRI and bone scan). I then learned I had metastatic or Stage IV breast cancer. My breast cancer had already spread to my spine when it was found.

I will always be in treatment for breast cancer. To date, one treatment has failed; I had a slight progression. I moved on a second treatment and have done well on that for two years. I am fortunate—because of the characteristics of my breast cancer (ER/PR+ and HER2-, the most common type), I was able to start on the very lowest end of the toxic drug spectrum. Eventually I will have to have chemo (and again, I will always be in treatment) but hopefully that won’t be soon.

Had I to do things over, I would have been proactive about getting a mammogram at age 40—and possibly sooner if my doctor had recommended it. I have a family history—my mom died of metastatic breast cancer at age 53. I am also of Ashkenazi Jewish descent—people of eastern European Jewish heritage have a higher risk for breast and ovarian cancers.

What would you say to other women around your age who are talking to their doctor about getting a mammogram for the first time?

Do not use the current mammogram controversy as excuse not to have one if you know there is a compelling reason for you to have this test. In my case, I had a higher than average risk for breast cancer.

Know the limitations of mammography. Mammograms do not come with a money-back guarantee and unfortunately their effectiveness is often exaggerated or misunderstood.

Young people tend to have dense breast tissue which does not image well—it is like looking for grains of white rice in a blizzard. Not all breast cancer has a lump—lobular breast cancer grows in sheets, for example. And my mom’s cancer—inflammatory breast cancer, doesn’t have a lump either. The breast can be red or swollen or take on an orange-peel like texture.

Unfortunately early detection is not a breast cancer cure. In fact, most of the 155,000 U.S. people currently living with breast cancer were originally treated for early stage breast cancer—their cancer came back 5, 10, 15 and even 17 years later—even though they took excellent care of themselves and had regular mammograms. It is very unusual for someone to be like me– diagnosed with metastatic breast cancer from the very start—this only happens 10 percent of the time.

With all of this being said, it would be wrong to say that mammography doesn’t save lives. But as the American Cancer Society’s Otis Brawley says, we need to use it with caution, explain its limitations and realize that we need a better test.

Although the median age for breast cancer is 61, young people can and do get breast cancer. Most people know that not having children increases one risk—probably because of the unopposed flow of estrogen. Fewer people know, however, that a woman’s risk for breast cancer increases after giving birth—for about 10 years. We don’t know why this is the case—researchers theorize it has to do with hormonal spikes that happen during pregnancy.

Most women of childbearing age are below the recommended age for a mammogram. Therefore, they should pay close attention to their bodies—if they sense something is “off” they should it bring to their doctors’ attention. Women in their 20s, 30s and 40s can and do get breast cancer.

No one dies from early stage breast cancer—the lump in your breast will not kill you. When cancer spreads beyond the breast—to bone, liver, lung, brain or some combination therein, it can no longer be cured. Obviously, it is better to find breast cancer before it can spread. But there’s also the challenge of over treatment. We don’t know which cancers seen on a mammogram would go on to spread and which would never do anything. So everything that is seen on a mammogram must be treated.

As patient advocate Musa Mayer says: “If we had spent a fraction of the dollars devoted to promoting screening on research to determine which DCIS lesions and tiny invasive breast cancers actually need treatment beyond surgery, and which do not, we’d be way ahead now.”

My other message is to find a group that can help you deal with your specific diagnosis. Breastcancer.org, Inspire.com and Living Beyond Breast Cancer are examples of groups that offer online support—including discussion boards—that make it easy to connect with others in the same boat. The Metastatic Breast Cancer Network (www.mbcn.org) really helped me—I attended its annual conference shortly after my diagnosis—it was the first time I met other people living with incurable breast cancer—they inspired me. There are few resources for people with Stage IV breast cancer—people tend to be more familiar with early stage disease where you are in treatment for a fixed period of time. Very few people grasp that not everyone “beats” breast cancer.

I look forward to seeing Camille Noe Pagan’s October 2014 article on “My First Mammogram” in Better Homes & Gardens.

Better Homes & Gardens sells  7.6 million copies each month.  I wish my story could have been in print. I’m glad it will be online. I hope people will read it and come away with a  better understanding of a complex issue and will be better prepared to discuss what is most appropriate for them with their health professionals.

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Metastatic Breast Cancer Events 2014: Mark Your Calendar

katherinembc:

Hi all, I am fine-but busy! Please note the following MBC events in North Carolina, Philly, LA, Boston and Chicago. Hope to see you at some of them!

Originally posted on MBCNbuzz:

Hi everyone. We hope you are enjoying your summer. We wanted to share a quick overview of upcoming metastatic breast cancer events in Chapel Hill, NC; Philadelphia, Los Angeles, Boston and Chicago.  I will be at three (!) of these events and look forward to meeting some of you there. Is there a metastatic meeting in your city we should know about? Please comment below.

–Katherine O’Brien

Secretary, MBCN

NC_StateIconThe Metastatic Breast Cancer Network’s (MBCN’s) 2014 Annual Conference In Conjunction with UNC Lineberger Comprehensive Cancer Center

WHO: People living with metastatic breast cancer and their spouses, partners, friends and caregivers

WHEN: September 19-21, 2014

WHERE: UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC

                                                    MORE INFORMATION: www.MBCN.org

NOTES:  MBCN’s signature annual event starts with a Friday night reception and goes on to include a full day of  Saturday sessions and a half day on Sunday. There are at total…

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Metastatic Breast Cancer at ASCO 2014: We Are There

katherinembc:

#ASCO2014 can be overwhelming but it is wonderful to be here.

Originally posted on MBCNbuzz:

Follow ASCO live via TwitterShirley Mertz, Ginny Knackmuhs and I are am among the 25,000 attendees at the 2014 American Society of Clinical Oncology (ASCO) Annual Meeting this weekend at McCormick Place in Chicago. We are there as a patient advocates with the Metastatic Breast Cancer Network.

ASCO isn’t just about breast cancer. There are sessions on gastrointestinal cancer, genitourinary cancer, head and neck cancer, lung cancer, leukemia, lymphoma and myeloma, melanoma and more. If oncologists put together Lolapalooza, this is what it would look like.

Prior to attending ASCO, I never gave any thought to the group’s name. I thought it was something between a service-type organization (like the American Legion) or an elite group of super smart people (like the National Honor Society). But in learning more about ASCO’s 50-year history, I have come to appreciate just how important the “Clinical” part of its name is.  As the the ASCO Daily…

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Where’s my clinical trial?

katherinembc:

Ginny Knackmuhs is fortunate: she has been living with triple negative breast cancer for five years. She’s very glad her disease has been quiet–she’s happy to be stable. But why aren’t we learning from people like her?
“Isn’t it worth looking at patterns that might emerge from studying all of us at this stage of our disease? asks Ginny. “Why are we among the enviable few of patients living with metastatic disease? Not to collect our data seems like a lost opportunity, a cache of valuable information that should be captured.”

Originally posted on MBCNbuzz:

by Ginny Knackmuhs, VP of MBCN

I’m one of the lucky ones, I know.

Although I was diagnosed with metastatic triple negative breast cancer 5 years ago, I have been on the same treatment regimen since then. No progression, just blessed stability. I hesitate to write that sentence or say it out loud—afraid I’ll jinx my good fortune, always mindful of the next scan around the corner, when everything can change in an instant.

Metastatic breast cancer (MBC), also sometimes called advanced breast cancer or Stage IV disease, is incurable, but still treatable. Oncologists like to say it is a chronic disease, but with an average life expectancy of 2.5 to 3 years, it certainly isn’t chronic yet. Give us 10 or 20 years of stable treatment and quality of life and we’ll be happy to call it chronic.

ImageNext week I’m going to ASCO in Chicago, the annual meeting…

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Metastatic Breast Cancer Makes Mother’s Day Difficult

I just finished reading “The Day I Started Lying to Ruth: A Cancer Doctor on Losing His Wife to Cancer.”   The author, Peter Bach, is a physician, epidemiologist and writer at Memorial Sloan-Kettering Cancer Center where he is Director of the Center for Health Policy and Outcome. He is a gifted communicator and this is a compelling–if sad and sobering–essay.

 

PeterBach

I was shocked and dismayed to learn that Dr. Bach’s wife, Ruth, died in January 2012 from metastatic breast cancer. She was 46.

I recalled the Bachs from a 2011 series of blog posts in the New York Times. The seven-part series started with “When the Doctor’s Wife Has Cancer” in February 2011 and concluded with April 2011’s “Back to Work and Life With a Fresh Perpective.”  In the April 2011 installment, all seemed well–Ruth’s hair had grown back following the conclusion of her chemo. The piece ends with the couple enjoying a gorgeous day at the beach with their son, a happy ending to what had been a frightening chapter in their lives.

So how could this woman possibly have died a mere nine months later?  Bach did not assign a time frame to his New York Times 2011 series–as many readers probably did, I assumed Bach was writing about events in real time, but that wasn’t the case. In his most recent article, we learn that Ruth was first diagnosed with breast cancer in 2008.  So the New York Time series actually described events from three years prior.

Still, even with this timeline clarification, the news is no less incomprehensible. In June 2011, just a few a months after the publication of the NYT series–and three years from her first diagnosis–the Bachs learned Ruth had a metastatic recurrence. She died eight months later in January 2012.

Bach’s thoughtful NYT series included this March 2011 reflection on the risk of breast cancer recurrence. A mere three months after that story was printed, he and Ruth learned her cancer was back (after three years), and this time it was incurable.

How awful for all concerned.

When I read Dr. Bach’s account of his wife’s experience with metastatic breast cancer, I felt a familiar blend of emotions: sympathy for Bach and his young son, anger that yet another young life was lost  and despair that even people as smart and well-connected as the Bachs were powerless against this insidious disease.

Mother’s Day is this Sunday, May 11, 2014. It will be hard day for the Bach family as well as the families of  some of their fellow Memorial Sloan-Kettering patients who lost  young mothers to metastatic breast cancer, including two who shared their diagnosis online and in print:

Meredith Israel, mother of a five-year-old died on December 23, 2012 at age 39.

Elisa Bond, also 39,  died on March 26. 2014, a few weeks prior to her daughter’s fourth birthday.

The following women were not MSKC patients and not all of them were mothers. But  they were all too young:

Lisa Lynch was 33.

Olga Simkin was 34.

Maria Madden was 37.

Jennifer Lynne Strutzel Berg was 37.

Susan Niebur was 39.

Beth Bell was 40.

Samantha Pritchett was 40.

Dana Robinson was 41.

Rachel Cheetham Moro was 42.

Zoh Vivian Murphy was 45.

Barbra Watson-Riley was 45.

Acacia Warwick was 46

Suzanne Hebert was 47.

Mary J. Corey was 49.

Shelli Gibbons was 49

Martha Rall was 49.

 

“We need focused research to change incurable metastatic breast cancer into a treatable, chronic condition like HIV-AIDS–where patients can now live for 20-30 years with treatment after their diagnosis,” says Shirley Mertz, President of MBCN. “If gay men, who were then scorned by society in the 1980s, could demand and receive focused research and treatments for their disease, why can’t we women–who are wives, mothers, daughters, sisters and grandmothers AND over half of the population–receive similar research that will find strategies to keep us alive for 20-30 years?

“Are we not worthy of this effort?  Are we ignored because we quietly live with our disease?”

Well, are we?

 

 

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Canadians Push for National Metastatic Breast Cancer Day Designation

katherinembc:

Kudos to patient advocate Laurie Kingston and our friends at the Canadian Breast Cancer Network!

Originally posted on MBCNbuzz:

LaurieKingston

We want to salute Laurie Kinsgston, a Canadian metastatic breast cancer patient advocate and author, for her work with  the Canadian Breast Cancer Network. On May 1, 2014,  Laurie and representatives from the Canadian Breast Cancer Network joined Liberal MP Hedy Fry to call attention to her private members’ bill to designate October 13th as National Metastatic Breast Cancer Day.

Laurie, who lives in Ottawa, learned  was first diagnosed in  breast cancer in 2006, when she was 38 years old, with two little kids. Three months after she completed treatment, she learned the cancer had spread to her liver. Treatment went well–seven months later, her  scans revealed no evidence of disease.  But in November 2012, she was diagnosed with brain mets.

“After conventional and cyber knife surgeries, I was once again able to embrace the words ‘no evidence of disease,'” she writes. “I will be in treatment for…

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Tests and Metastatic Breast Cancer: Living With Uncertainty

 

Click here to watch the video

Click here to watch the video

I just had my scans and I am glad to say I am stable.

But it made me think about how anxiety producing this is…and that most people don’t understand why we are having scans, how often we have them and why this is so emotionally draining. I made an attempt to explain it here: http://animoto.com/play/SSeFswBYB5dxZA401GWcEw

 

Credits: Ryan Shaw, currently portraying Stevie Wonder in the Motown Musical, is the
“Morning, Noon and Night” singer: http://www.amazon.com/Real-Love-Ryan-Shaw/dp/B007N8QAV0/ref=pd_sim_sbs_m_1?ie=UTF8&refRID=18FVAZRWYFWBCXMS5C6Y

….and Roger Hargreaves is the ” Mr. Men” artist and writer: http://en.wikipedia.org/wiki/Mr._Men

You can learn more about PET and CT scans here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1255942/

…and here are some bone scan basics: http://www.insideradiology.com.au/pages/view.php?T_id=25#.U2MUn1feTng

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There Are Some Second Acts in American Lives…for Bill Keller, Anyhow

new-job-congratulations-card

 

If I had LinkedIn ties to Emma and Bill Keller, I’d be sending them each congratulatory notes. Bill is now the  editor-in-chief of the Marshall Project, a start-up operation that will specialize in criminal-justice reporting. Emma, having tendered her resignation to The Guardian, has moved on to “several reporting and writing projects.”

Earlier this year, Emma Keller, writing online for the Guardian, questioned Lisa Bonchek Adams’ use of social media to publicly chronicle her  treatment for metastatic breast cancer. (The piece was subsequently withdrawn.)  Bill Keller’s NYT Op-Ed ran less than a week later and essentially portrayed Adams as a dying woman grasping at straws, suggesting her treatment equates to “endless ‘heroic measures’ that may or may not prolong life but assure the final days are clamorous, tense and painful.”

Neither  Keller apparently felt compelled to apologize or admit any culpability. They’ve both moved on to other things–“I found that I was lying awake at night thinking about how I could do this,” [Bill]  Keller said. “You always like to think that you have one or two more acts left in your life.”

When I consider the 65-year-old Keller’s decision to prolong his  career, I recall my own father’s decision to slip peacefully into retirement at age 63. Dad’s subsequent move to Florida  seemed to me a humane and honorable alternative to the frantic scramble to remain relevant and further burnish one’s professional accomplishments, activities that so often makes a misery of Monday through Friday for the cube dwellers who must support us in our dotage. . .

 

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I Was Not Just ‘Another Person’ With Metastatic Breast Cancer

katherinembc:

LBBC volunteer and MBC patient Caryn Kaplan shares her story of attending the group’s metastatic conference for the first time.

Originally posted on LBBC's Blog:

Caryn KaplanLast week we introduced new blogger but long-time LBBC friend and volunteer, Caryn Kaplan. In her first story she explained that her cancer had spread to her liver and bones and that she was diagnosed with breast cancer for a third time, this time with metastatic disease. Caryn has attended our Annual Conference for Women Living With Metastatic Breast Cancer for the past few years and here she shares her memories of that very first time…

As I started my drive down Interstate 95 towards downtown Philadelphia, listening to intently to my audio book, I found that my mind had drifted off the story and to a place that has a story of its own.  I was going to attend my first Women Living with Metastatic Breast Cancer Conference held by Living Beyond Breast Cancer.  I read about it on their website and received publications in the mail and to me-it was a…

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Grants Still Available for April 26-27 LBBC Metastatic Conference in Philly

LBBC Wants You!

LBBC Wants You!

 

Our friends at LBBC have asked us to remind you there’s still time to sign up for their conference.

Travel grants and fee waivers are available for LBBC’s Annual Conference for Women Living with Metastatic Breast Cancer on April 26th & 27th at the
Philadelphia Marriott West!

  • Hear the latest updates from some of the country’s leading healthcare experts on advances in care, symptom management, quality-of-life concerns and new clinical trials and their potential impact on emerging treatments
  • Attend workshops designed for the newly-diagnosed, women living long-term with metastatic breast cancer, triple-negative and hormone receptor-positive diagnoses types, young women and caregivers
  • Network with peers, listen to their experiences and share your own
  • Get your questions answered by experts
  • Visit with exhibitors
  • Participate in healthy living activities (including an all-levels yoga class!)
  • More info here: http://www.lbbc.org/Events/Metastatic-Breast-Cancer-Conference/2014-04-26-Metastatic-Breast-Cancer-Conference

I can’t make this one, but it’s an excellent conference. The Metastatic Breast Cancer Network (MBCN) will be there…stop by the booth to say hello to my friends Deb and Melanie!

More Info Here

More Info Here

 

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