31.12.13 / Breast Density, Uncategorized / Author: admin / Comments: (2)
My Mum passed away in 2001 from secondary breast cancer in the Liver. It had metastasised. It was 3 weeks before her 61st birthday.
From then on I had annual checks on my Breasts.
I had always been told I was ‘lumpy’ and had dense breast tissue. Every now and then there was a lump that was investigated through an FNA (Fine Needle Aspiration). But everything was clear.
This year (2013) I went to the Dr for my usual ‘girl’ checkups, including a breast check. I mentioned that I’d been particularly sore on the right side and that it seemed to last a lot longer than the usual menstrual cycle issues. She agreed I was very lumpy, and suggested I see a new Radiologist who specialises in Breasts. The downside was that it was a private practice and I would end up paying more. He might even suggest an MRI (Magnetic Resonance Imaging) scan.
But off I went. I had the usual Ultrasound and Mammogram and everything was clear. I also had a consultation with the Radiologist, Jeremy Price, in regards to Genetic Testing. As my mum was the only family member we know of that has had Breast Cancer, my risk was very low, so we decided not to do the genetic side of things. I also later found out that the tests are quite expensive.
However, further discussion around Breast Density decided me on having an MRI, just to be sure.
Jeremy found a lump in my right breast but thought it was a Fibroaedenoma. A biopsy would confirm if this was the correct diagnosis. It was a slippery little sucker to find! The radiographer couldn’t find it with ultrasound so went out to get Jeremy. In the meantime, I rolled onto my left side and located it right around near my armpit of my right breast. Lying on your side is not a position that we are suggested to use during self checks! But this appeared to be the only way to locate it.
Even after I located it, finding and keeping it in the viewer proved challenging – but the biopsy was finally done.
Four days later, my Dr rang with the news that the biopsy showed an Invasive Ductal Carcinoma (IDC) and my Breast Cancer Journey began.
The lump was approximately 5mm (very small) at the time of the biopsy.
Nearly 3 weeks to the day of my diagnoses, I was in surgery for my lumpectomy. Five lymph nodes were also removed. These are checked while you are under anaesthetic using a quick test by a pathologist who is in the Theatre at the time of your surgery. This is so they can decide if they need to do a full auxiliary clearance while in surgery (i.e. remove all the lymph nodes) if cancer has been detected. No cancer was detected in my quick tests. However, the lump and nodes are still sent off for full pathology. And you get to wait 10-14 days for the results. This can be hard, but I kept positive and busy until the results.
In the meantime, I read and read and read (see ‘Taking Control’). By the time I got my results at the next surgeon’s consultation, I had a good understanding of what they, and the report, were saying. I also made sure I was given a copy of the report for my files. Keep copies of EVERYTHING.
The lump was 2.5x2mm (some had been removed during the initial biopsy), margins were clear, all 5 nodes were clear. I was HER2 negative (this is good) and the cancer was Oestrogen and Progesterone positive (also good as this can be treated with hormone receptive drugs).
Bottom line: we got it all, you won’t need chemotheraphy, you will have a 6 week course of Radiation Therapy, then go onto Tamoxifen for 5 years or until menopause.
BREATHE.
23.07.14 / Uncategorized / Author: admin / Comments: (0)
I haven’t written for a while. Life has been very hectic. But I was lying in bed the other morning and I thought to myself “I’ve had Breast Cancer. I’ve beaten Cancer!” And it made me have a look at what I’ve been doing for the past 9 months, what has changed and how I keep myself as stress-free as possible.
While I’m employed at the same company, I’m working with a different company and with an end client I’ve not worked with before. Pretty much like starting in a new job – where you know very little. Stress-City! But in the 2 months or so that I’ve been there, I’m quite proud to say that I haven’t let myself get too stressed. It’s hard work to do that! There was one day when I ended up with a revolting migraine and then had to take stock. What had changed?
I had stopped doing my 10 minutes of meditation each morning.
I had stopped walking/jogging with the dogs daily.
I had stopped doing my affirmations.
I had stopped eating as well as I had previously.
I was not being as diligent in writing my daily gratitude list.
Basically I had fallen back into pre-Cancer old habits, and add to that a stressful work environment, and here comes the Migraine. My head was still physically sore for the next 2 days!
I’m doing everything I can to keep myself as stress-free as possible, as I fully believe stress is what gave me my Breast Cancer. And I sure don’t want it again.
Everyone finds balance differently. What I’m finding is working for me is the following, and I don’t always do each of these every day:
- Write 5 things each morning that I am grateful for
- Do 10 minutes of meditation (I have a number of apps on my phone that I use)
- 30 minutes of exercise (some upper body weights to keep my arm and scar in good shape and some additional exercises for my neck)
- 20-30 minutes of walking the dogs (sometimes I jog this, depends on how cold it is outside!)
- I have my affirmations laminated and hanging on the outside of the shower screen, so that I can say them every morning. Unless I don’t shower (!), this ALWAYS gets done.
- Spend the first 15-30 minutes on a Monday at work planning my week and then 10 minutes each day. I find this really focuses me.
- Bring my own lunch to work. That way I’m not tempted away from my healthy eating. I also have lots of good snacks for during the day, and my teabags.
- Try to drink 3 litres of water a day. This is REALLY difficult. I’ve worked out that I have to have 4 of the 750ml drink bottle, but it is still quite a challenge to drink that much water.
- Do a set of my Tai Chi (www.taoist.org.au). This only takes 15 minutes and 100% resets me after a long, hard, trying day. I simply cannot think about anything else when I’m doing my Tai Chi.
- Say my additional affirmations each night just before bed.
Wow, when I write that all out it seems like a lot, but like anything, it’s just a matter of making it a habit. Check out this book ‘Why People Fail’ by Siimon Reynolds, as it was something I had started using prior to my diagnosis, but really helps keep you focused on what is important. His website is www.siimonreynolds.com
Since my diagnosis and treatment, I have had 3 women I know, all with dense breast tissue, go through their own journeys. Luckily they were all clear, but it just goes to show: having Dense breasts is really prevalent. Two of these friends had MRIs to confirm no cancer, and one also had a core biopsy.
The third had a core biopsy, and while the pathology suggested it was ‘a-typical’, she opted for a lumpectomy to remove those cells. No further treatment required other than ongoing vigilance.
After your diagnosis, do whatever will work for you to find balance and as stress-free environment as possible. If any of my balance items help you, then that is great!
Keep Positive. Keep Balanced.
03.04.14 / Uncategorized / Author: admin / Comments: (1)
The Stats say that we have more chance of dying every time we get into a car than, for example, a plane. But once you get a diagnosis of something like Cancer, the Mortality Mirror is suddenly right there, all the time.
Don’t get me wrong, I’ve had a Will in place for many years (I have a child to look after), but even though we know that cars are the quickest way to die, it isn’t foremost in our minds every time we get into one. It’s more likely thoughts of what to get at the grocery store, or that you must get petrol, or ‘yay’ we are off to the beach for the weekend. I’m sure other Cancer survivors will understand when I say that now, every niggle, ache, strange sensation, pain or twinge, now takes on a hyper inflated sense of worry and concern because of that darn Mortality Mirror. We have had a disease that might come back. It’s the monkey on your shoulder all the time. It’s real. And it’s scary.
I still have days every now and then when I have to remind myself that I’ve had Breast Cancer, and it kind of scares me that I can actually forget. But by the same token, I don’t want it to be top of mind all the time either. It’s hard finding that balance of vigilance and being able to successfully get on with your life without fear paralysing you.
Mortality is something that is a certainty for us all. However, I think the majority of us don’t spend everyday considering this and worrying about it. We don’t often think we are invinsible but we also don’t expect our lives to be cut short.
So is the Mortality Mirror a blessing or a curse?
I guess, like many things, it’s how you decide use the information in your life. Are you going to let it define you and rule your life, or are you going to use it to make you stronger and enhance your life? Are you going to sit back and have the ‘why me’ pity party, or go out and live life with a party?
The Mortality Mirror is now going to be with me for the rest of my (very long) life, but I’m not going to let it control me. I’ve already gazed into it and it doesn’t scare me. I have my low moments, but I had this pre-Cancer diagnosis too and I got through them, so I will get through those future low moments the same way. With love, and plans, and friends, and family and spirit.
01.03.14 / Uncategorized / Author: admin / Comments: (0)
There is always something in the media about Breast Cancer. While it is not the biggest killer of women in Australia (although, depending on where you look, you can get a different answer), it certainly has one of the best research and media campaigns, and I for one am grateful.
Ultimately, every woman has to take control of her own health, and management of that health. A recent article by Mi-Jung Lee in Canada, highlights that you can’t always rely on just one screening technique. Particularly if you know you have dense breast tissue.
Like me, Mi-Jung Lee had had regular checks, via Mammogram. Yet her cancer was not detected via this method, but instead through an Ultrasound.
I also recently came across a non-invasive method called Digital Infrared Thermal Imaging (DITI). Like everything, it has both its sceptics and champions. I’ve had it done, and it gives me peace of mind on two fronts:
- I am covering my bases by using various different types of screening
- I am using something that does NOT involve radiation, or nuclear medicine, x-rays or other harmful things to my body.
Take Control of your health. Find out if you DO have dense breast tissue. Talk to your GP or alternative health practitioner. Determine the right combination of screening and examination for you and your lifestyle, and what will give you the highest level of comfort that you are doing everything you can to catch this thing early.
Tell your family, friends, work colleagues. Educate.
05.02.14 / Definitions / Author: admin / Comments: (6)
Biopsy – This is the removal of a sample of tissue from the body to test and diagnose for disease. Also called a Breast Core Biopsy.
DCIS (Ductal Carcinoma In Situ) – abnormal cells changes that are contained within the milk ducts of the breast. Sometimes called pre-cancer or pre-invasive cancer.
Further information here: http://canceraustralia.gov.au/affected-cancer/cancer-types/breast-cancer/about-breast-cancer/types-breast-cancer/what-ductal-carcinoma-situ-dcis
DITI (Digital Infrared Thermal Imaging) – is a modern completely safe, radiation free medical technology that involves no contact, compression or discomfort.
It records your skin surface temperatures which can reflect the health of your body.
Infrared technology can detect abnormal infrared patterns in soft tissues including nerves, muscles, tendons, ligaments and organs (physiology). It can show areas of inflammation, infection, injury, nerve irritation/under activity.
Fibroadenoma – is a tumour in the breast, usually benign, made up of mixed fibrous and glandular tissue.
Further information here: http://www.thewomens.org.au/uploads/downloads/HealthInformation/FactSheets/English/BreastCare/fibroadenomas_English.pdf
FNA (Fine Needle Aspiration) – procedures used to investigate superficial lumps or masses. A thin, hollow needle is used to take a sample of cells from an organ or lump under the skin. If the lump can’t be felt under the skin (ie it isn’t palpable), an ultrasound may be used for guidance. The sample is then sent to pathology for examination.
IDC (Invasive or Infiltrating Ductal Carcinoma) – abnormal cells changes in the milk ducts of the breast. Invasive means the abnormal cells have spread out of the duct and into the surrounding breast tissue. This is the most common type of Breast Cancer.
Mammogram – Low dose Xray used for screening and diagnosis of breast tissue.
Further information here: www.breastscreen.org.au, www.cancer.org.au, www.bcna.org.au/living-breast-cancer/follow-care/breast-imaging
MRI (Magnetic Resonance Imaging)– allows viewing of the soft tissues of the body. It is painless and does not use Xrays. It uses a very large magnet and very low-energy radio waves. Diseased tissue gives off a different signal from healthy tissue, which the MRI detects.
A standard MRI for breasts takes approximately 30 minutes. You will usually be lying face down. A contrast dye is sometimes also injected to allow greater visibility of the tissue.
Radiographer – medical imaging technologist who performs medical imaging using and producing high quality Xrays used to diagnose and treat injury or disease.
Radiologist – specialist medical doctor with postgraduate training in performing and interpreting diagnostic imaging tests and procedures (i.e Xray, ultrasound and MRI).
Ultrasound (also called a Sonogram)– Uses high frequency soundwaves to study internal structures of the body. The reflected sounds or echoes create and image for the Radiologist to read and interpret. Ultrasounds are mainly non-invasive (except for pelvic or obstetric examinations).
09.01.14 / Breast Density / Author: admin / Comments: (3)
As mentioned, an MRI uses magnetic resonance imaging to provide pictures for a Radiologist to interpret. It is basically a very large magnet. In order to have an MRI done, you need to remove all metal objects, even metal clips on bra straps can be pulled in! Apparently if you Google ‘strange objects in MRI’, there are many pictures of MRI’s with such things as floor polishers that have been sucked into them! A very expensive exercise I imagine.
Once you are metal free, you need to have no clothing on the top half, wear a gown and paper hat…. very glamorous. They will also put a cannula into your arm. This is so they can inject a contrast agent during one or two of the scans. You then lie face down on the bed, like when you have a massage, except your boobs are hanging down through the bed (also very glamorous!). The good thing about being face down is that you don’t really notice going into the machine. The bed moves really smoothly too. There is plenty of light and therefore less potential for claustrophobia. Personally, I closed my eyes and went to the beach. They also hook up the cannula to the components that will inject the contrast agent, this is all done remotely as they can’t enter the room once they start all of the scans.
So you are face down on the bed, face is in padded hole, boobs hanging down. You’re arms will be stretched out in front of you. If you are not flexible, like I’m not, your arms will go numb. You can ask for foam to be placed under different parts of your arms to help with comfort. You will be lying like this for about 25-30 minutes. They also provide earplugs and earphones, some places will provide music if you want. MRI’s make LOTS of loud noise, rhythmic banging and knocking, not so bad that you have to wear the earplugs and headphones, but pretty darn loud. When it’s not making noise they are readjusting the set up to take the next scan, and this is when you can wriggle fingers etc to keep somewhat comfortable.
There is also a microphone so if you are uncomfortable you can let the operators know at any time.
25-30 minutes later it’s all done, you’ll come out of the machine, have the cannula removed, get dressed and head home. The results will be provided by Radiologist either directly to you or to your GP.
As mentioned, my initial MRI diagnosis was an approximately 10mm mass that the Radiologist believed was a Fibroadenoma. This mass did not show on either the Mammogram or Ultrasound I had already had. To be conclusive, an ultra-sound guided Biopsy was recommended. It’s kind of like saying ‘may contain traces of nuts’, they have to cover themselves but it is ultimately your decision as to whether you choose to go forward with the biopsy or not. Because I had had so much discomfort/aching around my right breast several times over the previous 9 months or so, I decided on the biopsy.
And that is how my cancer was found.
That MRI allowed the lump to be detected early (it ended up being around 5mm but after the biopsy, surgery only had 2.5 x 2mm left to remove).
I am so grateful to Jeremy Price for his honest and open discussion with me around breast density and how an MRI is the best way to see early masses in breasts. I am also so grateful that I am in a position to be able to afford the cost of full payment for that MRI.
We need to work on the Government to get MRIs for women with formally graded dense breast tissue to have some subsidy for the costs of the MRI.
Listen to your body, and do whatever you need to do to be comfortable that everything is OK.
31.12.13 / Breast Density / Author: admin / Comments: (0)
In the USA, a law was passed in 2009 in Connecticut related to notifying women of their breast density based on their mammograms. Physicians are required to send a letter. Other USA states have also passed similar legislation.
This is a tricky area, as density is only one factor that should be taken into account by women in regards to any decisions made.
Further Information: http://breastscreeningaustralia.com/2013/08/15/national-breast-density-notification-amendment-advances/
31.12.13 / Breast Density / Author: admin / Comments: (0)
So you now know, from your Doctor, that you have dense breasts. Hopefully, they have given you an indication based on the BI-RADS system.
Grade 1 and 2 have a small elevated risk.
Grade 3 and 4 have a higher elevated risk. This does not mean you have to panic!! What is DOES mean is that you need to be especially vigilant. You really have to know your body, and more importantly, LISTEN to your body.
You need to talk with your doctor about other factors such as age, weight, pre or post menopause, hormonal treatment, diet, family history and genetics. And THEN you have to add in your breast density. Density should not be the only driver in your decisions. Speak with your Doctor and/or a specialist Radiologist.
If you are over 40 and are not already having regular mammograms, start having them now. In Australia, BreastScreen provides these free every 2 years once you are over 40. Mammograms are not embarrassing (the radiographers sees hundreds of boobs each week), and they are uncomfortable for seconds only. Surely this is a small ‘price’ to pay for some peace of mind.
If you decide you want to be more vigilant, perhaps include Ultrasounds. And, if you want to go further, perhaps an MRI every 2 years. MRI plus Mammogram is a good combination, perhaps alternating each year.
This is a very personal choice, and is also dependent on your monetary situation. MRI’s are not cheap and are not covered by Medicare in Australia.
Now, I know and understand that some women don’t get checked because they don’t want to have the potential for a negative outcome. They don’t want to find a lump. This is a tough one. No-one wants to find a lump or abnormality. EARLY DETECTION IS KEY TO A POSITIVE PROGNOSIS. The statistics show that the earlier and smaller the cancer, the better the long term prognosis. It can often mean a much shorter and less intrusive treatment cycle as well.
31.12.13 / Breast Density / Author: admin / Comments: (1)
The American College of Radiology (ACR) developed a standard way of describing findings from a mammogram. It is called the Breast Imaging Reporting and Data System (BI-RADS). BI-RADS includes a category for reporting breast density.
BI-RADS 1: Less than 25% of the breast is fibrous and glandular tissue
BI-RADS 2: 25% – 50% of the breast is fibrous and glandular tissue
BI-RADS 3: 51% – 75% of the breast is fibrous and glandular tissue (this means it is now becoming more difficult to see small masses such as cysts or tumours)
BI-RADS 4: More than 75% of the breast is fibrous and glandular tissue. This is where some cancers can be missed
BI-RADS is not routinely recorded in Australia, except in Western Australia.
How this grading looks in pictures
31.12.13 / Breast Density / Author: admin / Comments: (1)
So, you’ve been told your dense …. Well, at least your Breasts are dense! What does that actually mean?
Breast Density looks at the different tissue within your breast, and what it is made up of. It can be made up of fatty (non-dense) tissue and connective (dense) tissue. Dense tissue can be: fibrous or glandular tissue.
Your breast density can be measured with a mammogram. The breast tissue will show up much more white than less dense tissue, which will show as grey and transparent. You might feel quite thick and lumpy all the time, and for women, not just when menstrual.
Breast Density decreases with age and after menopause due to hormonal changes. But it is different across women of the same age. It is also higher in pregnancy and lactation. Hormonal therapy can also increase breast density.
It is recognised that increased breast density means there is also an increased risk of breast cancer, while leading to a lower accuracy or ‘sensitivity’ of mammographic screening for cancer detection. But this is a controversial area.
The main issue in Australia is that women who have dense breasts on a mammogram are not currently monitored any differently from other women. Even though there is mounting evidence to suggest that breast density is linked to a greater lifetime risk of breast cancer, more aggressive tumours and a 50% change of screening missing tumours.
Further information here: http://www.breastscreen.health.wa.gov.au/docs/BSWA_BreastDensityInformationSheet_March2013.pdf
31.12.13 / Uncategorized / Author: admin / Comments: (0)
On the day of my diagnosis, I was referred to a local surgeon and met with him the following week. He seemed nice and knew his stuff.
However, I had been fortunate (or unfortunate depending on how you look at it), to know of 4 people in my circle of friends who had all been through Breast Cancer in the past 2-3 years. I had arranged to speak with all of them within that first week, and one of them gave me a fabulous book called ‘Breast Cancer: Taking Control’ by John Boyages. I highly, highly, highly recommend this book. It is written for the layperson and gives you all the facts you might want or need in your journey. You don’t have to read it all, but just the chapters that are relevant, or if you are like me, you read it cover to cover! The information CAN be confronting, but I prefer to be armed with information. I take it IN, but don’t take it ON. My journey is my journey, and won’t be the same as anyone else’s.
One of the first things stated in the book is that, while a breast cancer diagnosis is horrible and confronting and scary, it is not a medical emergency and as such you do have some time to take control and make some decisions. Of course, we also don’t dawdle!
I decided I wanted to speak with another surgeon to see if I felt differently with them. This was arranged for a week after the first (which still fell within the 3 week window for surgery with the first surgeon).
Due to reading the book, I went armed to both surgeons’ consultations with knowledge and questions. I also made sure that I had someone else with me during the consultations as, with the best and strongest will in the world, this is YOU they are talking about, and you have BREAST CANCER. So your brain can turn to mush!
I also asked permission to record the conversation on my smart phone.
As a result of going in armed with information and questions, I felt I got a really good understanding of both surgeons, and one of them just gave me much more information and detail (without me asking), compared to the other. And I felt more comfortable with them too.
It also felt really good to be making this decision MYSELF. You don’t have to blindly follow what the Doctors say to you. This is YOUR life, YOUR body and YOUR decisions. Take control.
What sort of questions did I ask?
- What percentage of your surgery’s are breast?
- How often do you need to go back for further surgery (ie. Initial node check was a false-negative or margins were not clear around the lump)?
- Do you use subcutaneous (under the skin) sutures? (This gives less of a scar)
- What is the recovery time, both in hospital and at home?
- Will I have a drain?
- When will I get full results?
- How do you perform a mastectomy? (There are varies methods used by different surgeons)
- Do you also do breast reconstruction? If so, what method do you use?
I was not going to be led by the medical personnel involved in my journey. I would absolutely listen to what they had to say, and all of that information would become part of my decision making process. But you do have options and these are your decisions to make. Granted, when you are trying to process and come to terms with the fact that you have Cancer, and all the possible ramifications, it can be very hard to have a clear head.
Surround yourself with strong, supportive, loving people who can take on some of the small stuff (i.e. meals, cleaning, running kids to school and activities, etc), while you make your assessments of what needs to happen for YOU. For many people, asking for help is hard. I’m one of those people too. But this is really, really important. There’s a lot to assimilate and a number of different paths that can be taken, and you need to have a clear space in your mind to digest it all and come out the other side with the right plan for you AND your family.
Take Control.
Buy John Boyages book or the ebook.
