Let's Talk About Breasts
Author: Courtney Hampson
Is that a lump? That can’t be a lump. Shoot. I think that’s a lump. Ten more minutes of fondling myself, in the shower, and I finally called in my significant other for a second opinion. The initial grin on his face slowly turned to concern as he realized what I was actually asking him to do. His voice was barely audible when he murmured, “Yes sweetie, I think that’s a lump.”
As I swallowed back the lump in my throat a million thoughts went through my head. With a family history of breast cancer, I had almost been waiting for this moment. Oddly, I felt a little relieved that I could identify a lump. I mean, my greatest fear was that I would never notice a lump until it was too late.
This discovery came just before Thanksgiving, so I tried to ignore it until after the holiday. And by ignore it, I mean will it away. At Thanksgiving dinner, my mom shared that a friend of hers had just been re-diagnosed (yes, diagnosed for a second time, after a mastectomy years ago) with breast cancer. I didn’t think it was the time to reveal what I had found, so I let my mashed potatoes be the only things with lumps at the table.
The following week I went to my primary care doctor to see if I was crazy. I wasn’t. She felt it, too, and told me that I needed a mammogram; she referred me to Dr. Virginia Herrmann, medical director of the Hilton Head Hospital Breast Health Center and professor of surgery at MUSC. According to my doctor, Dr. Herrmann is “the be-all and end-all doctor when it comes to breasts.”
I was a little shocked, and more worried, that she made the appointment for me right there. Still under the 40 year mammo-mark, I hadn’t yet experienced the pleasure of a mammogram, but I had heard of the delight I was about to incur. Two days later, I was naked from the waist up being pressed like a pancake. I was impressed that the films immediately went to a radiologist while I waited. I was less than happy when the radiologist insisted that they do the mammogram again and even more disappointed when I was told to come back the following week for an ultrasound to take a closer look. A week? I have to wait a week?!
One week later, and after Google set my expectation that 95 percent of the time, it’s a cyst, I learned from the ultrasound tech that it, “definitely isn’t a cyst.”
Two weeks later, I underwent a needle biopsy (which by the way feels and sounds like a gunshot to the chest). Forty-eight hours after that, I cried with relief when I learned that the lump was a benign fibroadenoma. Despite the benignity, but because of the size (larger than 2 cm), I did have the lump removed about a month later, only to learn it was actually two lumps. Both benign. Sweet relief.
So now I have this scar that has dashed all of my dreams of posing in Playboy. (Well, the scar and my cellulite.)
With my Playboy retirement plan no longer an option, I knew I wanted to tell my story. But, I also struggled with a little guilt about telling a story that, while fraught with emotion and more than one tantrum, actually ended with good news. A lot of women don’t get good news.
When I expressed my hesitation to Dr. Herrmann, she said, “Why? Benign beast disease is also a problem that needs attention.”
So, let’s talk.
As I sat in the Hilton Head Hospital Medical Pavilion waiting to interview Dr. Herrmann for this piece, a woman entered the waiting room with an open umbrella and all I thought was “Close your umbrella. Don’t you know that’s bad luck! Look around, we all need good luck here!”
The bottom line is, no one truly knows what causes breast cancer, so is it luck if you dodge the diagnosis?
Either way, if you are reading this—man or a woman—you are at risk. But yikes! Do we want to talk about that? Of course not. Society doesn’t like to talk about uncomfortable topics. Especially cancer. And if the cancer is related to a sex organ, well then forget it.
In the middle ages, women went into seclusion if they were diagnosed with breast cancer. In fact, it was Queen Anne, mother to Louis XIV who first made breast cancer public in the 1600s.
Even in the present, we hesitate to talk about breast cancer. Dr. Herrmann tells me that a lot of women don’t even know their family medical history. “My grandmother had breast cancer, but we never really talked about it.” Well, why not?
Despite the hushed voices and the stigma associated with cancer, breast cancer gets a lot of media coverage. Why? Because if detected early, the large majority of women survive. There are more joyful endings than not. Breast cancer doesn’t claim the number of lives that other cancers do. That’s the good news.
But, Dr. Herrmann notes that a lot of the public support for breast cancer almost trivializes the disease. Campaigns to “save the tatas” and “do it for the boobs” irk Dr. Herrmann and her colleagues. She says, “A boob is a stupid person. Breasts are a beautiful part of the anatomy.” So, let’s talk about breasts.
Breast cancer is rare in women under 40, and still not common in women under 50. Chances of breast cancer increase with every decade. Most lumps are benign. If you are like me and have a “busy breast,” it means that your breast is prone to developing things, and yes, you have an increased risk of developing cancer but you also have now been alerted to the fact that you need to be vigilant. This is why identifying any issues early and treating them, is key. Also important to the equation is identifying if you are at a higher risk (family history, never had children, or a late life pregnancy can be contributors) and tackling prevention methods: mammograms, ultrasounds, increased surveillance, weight maintenance, exercises and alcohol moderation, to name a few.
One in eight women in the country today will be diagnosed with breast cancer with no family history. For infants today, the chances increase to one in seven. This data suggests that a paradigm shift is necessary. We need to focus on prevention.
“In all industrialized countries, cancer risk is high,” Dr. Herrmann said. “It’s because our body mass indexes are so high, and our alcohol intake is elevated.”
Up until 1978 women died of breast cancer at some stage. When mammography technology came on the scene, screenings began to find the 30 percent of breast cancer that was identified as stage zero. (I didn’t even know there was a stage zero.) That number alone tells us how important screening is.
So, what do I want you to do? What does Dr. Herrmann really want you to do? If you are between the ages of 35-40, schedule a baseline mammography. If you are younger than 35, and your mother or sister has had breast cancer, get a mammogram 10 years earlier than when your family member was diagnosed. If you are older than 40, you are already behind. Make an appointment.
According to Dr. Herrmann, “In the group most at risk, women between 40-49 years old, five women will undergo an additional biopsy procedure for every breast cancer detected. Annual mammography in this group will reduce breast cancer deaths by at least 15 percent. There is plentiful data that earlier detection results in less aggressive treatment and improved survival.” For all women.
You can walk into any imaging facility and get a screening mammogram. No referral from your doctor is required. Insurance covers one per year. If you don’t have insurance, I implore you to go anyway. At Precision Imaging on Hilton Head, the cost is $207. Sounds like a lot? Well, it’s not much more than what you spend on a haircut and dye job, or a mani/pedi combo, or a $5 coffee drink every morning.
Just do it. It could be the best money you ever spend.
THE FIVE STEPS OF A BREAST SELF-EXAM
Step 1: Begin by looking at your breasts in the mirror with your shoulders straight and your arms on your hips.
Step 2: Now, raise your arms and look for the same changes.
Step 3: While you’re at the mirror, look for any signs of fluid coming out of one or both nipples (this could be a watery, milky, or yellow fluid or blood)
Step 4: Next, feel your breasts while lying down, using your right hand to feel your left breast and then your left hand to feel your right breast.
Step 5: Finally, feel your breasts while you are standing or sitting. Many women find that the easiest way to feel their breasts is when their skin is wet and slippery, so they like to do this step in the shower.