|Date of diagnosis:|
May 20, 2013
|Age at time of diagnosis: |
|Stage of diagnosis: |
Last 'NORMAL' Mammogram:
10 months prior to diagnosis
How was cancer diagnosed:
Amy felt it
I was diligent about annual mammograms once I turned 40 in 2001. In July 2012, I had my annual “normal” mammogram. In March 2013, while soaping my body in the shower, the outer side of my right breast felt hard. I immediately made an appointment with my OB-GYN; when she examined my breast, she said: "I don't feel anything; you just have very dense breasts." I responded: "Really? Because it didn't feel like this before." She answered: "Well, if it gives you more peace of mind, I'll write you a prescription for an ultrasound." That was the wrong wording for someone who took pride in not being neurotic, so I thought her physical exam was enough. I knew nothing then about dense breasts.
Two months later, I thought: "I should get that ultrasound, because it still feels not normal." The ultrasound showed a mass, and a biopsy determined I had invasive ductal carcinoma. It was a 5.2 centimeter tumor with cancer found in three of four nodes taken, making it Stage 3A. I had a lumpectomy, four rounds of chemo, 6.5 weeks of radiation, and I've completed more than four years on Letrozole (Femara) so far. So much for mammogram and early detection!
While reading The Wall Street Journal when waiting for biopsy results, I learned that my state of California was one of the states then passing a law that women must be told if they have dense breasts when that fact is learned during mammogram. I now know that just being told you have dense breasts is not enough -- you need to know that mammogram is not reliable for early detection in dense breasts AND it is essential to have another diagnostic exam such as ultrasound or MRI, every year.
My shocked best friend in NY said: "My doctor always writes a prescription for an ultrasound with my mammogram because I have dense breasts." I never knew to ask for that. Why did her doctor know, and mine – a top OB-GYN in LA -- never did? Furthermore, when a breast cancer surgeon I consulted requested my mammograms for his review, I wound up seeing that while the mammogram facility always sent me a one-page "all is normal" letter, they were sending a two-page report to my gynecologist that always mentioned my dense breasts.
I still have a yearly mammogram (recently switched to 3D/tomosynthesis). I also get an Automated Whole Breast Ultrasound, six months apart from the mammogram. No medical professional will say I can skip the mammogram (and its radiation). I need to determine if the ultrasound is a proper replacement, and/or get an MRI instead.
The bottom line is that women need to know if they have dense breasts and that mammogram is not sufficient and insurers need to pay for additional diagnostics. Shouldn’t my insurer want to pay the $350 fee for my automated whole breast ultrasound, which would have caught my cancer early and saved the $164,000 they paid for four rounds of chemotherapy?
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Breast density is one of the strongest predictors of the failure of mammography screening to detect cancer.
Two-thirds of pre-menopausal women and 1/4 of post menopausal women have dense breast tissue.
Adding more sensitive tests to mammography significantly increase detection of invasive cancers that are small and node negative.
American College of Radiology describes women with "Dense Breast Tissue" as having a higher than average risk of Breast Cancer.
While a mammogram detects 98% of cancers in women with fatty breasts, it finds only 48% in women with the densest breasts.
A woman at average risk and a woman at high risk have an EQUAL chance of having their cancer masked by mammogram.
Women with dense breasts who had breast cancer have a four times higher risk of recurrence than women with less-dense breasts.
A substantial proportion of Breast Cancer can be attributed to high breast density alone.
Cancer turns up five times more often in women with extremely dense breasts than those with the most fatty tissue.
There are too many women who are unaware of their breast density, believe their “Happy Gram” when it reports no significant findings and are at risk of receiving a later stage cancer diagnosis.