Much has been written (positively and negatively) about these two important breast cancer topics. Health experts can't seem to agree as to whether yearly mammograms really reduce death rates from cancer, or to the effectiveness of monthly breast self-exams. Oftentimes, the people who weigh in on these topics rely on statistics, studies, life expectancy, and other numbers. Its good information and I read it with care, noting what the experts recommend.

Yet I know from personal experience that our bodies don't always follow the numbers and play by the rules. Regardless of what the experts think, both self-examination and mammography have been essential to my life.

My Self-Examination

I was 39 with a child in the second grade. I exercised regularly, ate reasonably well, didn't smoke, and took care of myself. The big health blip in my life had come two and half years earlier when I had a suspicious mole removed. It was melanoma. My surgeon took a nice chunk out of my leg to get good clean margins. Even so, I felt lucky because the cancer had not spread. I had routine check-ups and tried to keep a watchful eye on my body. I was on my way to the five-year mark and was more comfortable with my survivorship. I had decided early on that I was not going to let cancer—the dreaded six-letter word—define who I was or would become. And I wasn't.

However, then one night I found a lump in my breast that felt like a BB or small pea, and I was drawn back into a black hole of fear. I instinctively knew something was wrong. I went in for a mammogram, but it showed no sign of cancer. A sonogram found the small orb, but it didn't look atypical either. The verdict: an occluded milk duct. No worries. My doctors suggested I could wait and come back in six months for a recheck or, if I preferred, they could do a biopsy on it. I slept on this information, talked with family and friends, and prayed about it. On what was basically just a gut instinct I chose to have it taken out. (After all, it was my intuition that led me to have the suspicious mole removed even though a few months before at a public skin cancer screening I was told it was nothing to worry about.)

I was right. It was cancer—Stage I, ductal carcinoma in situ (DCIS). Given the option of lumpectomy followed by radiation, or a mastectomy, I chose the former. My lymph nodes were removed (this was at a time before removing the sentinel node only was an option) and all were clear. Luckily, because of the size of the tumor, I did not have to have chemotherapy. For the next 17 years, I remained vigilant about monthly self-exams and yearly mammograms.

My Favorite Mammogram

All seemed to be going swimmingly in the breast department. I felt no lumps or bumps. However, this time around it was not my trusty fingers, but my annual mammogram that caught my second breast cancer. I was so surprised when the doctor reading the mammogram called me back into the exam room. She placed the film over the light panel and showed me the suspicious area that they had found. Really, that's it? That is my new nemesis? To me, it looked like barely perceivable dots. A fine-needle biopsy later confirmed it was again DCIS. I was in shock. My keen perception that guided me so well in the past had failed me this time.

Although this cancer appeared in the same breast as my first breast cancer, it was a separate occurrence, not a metastasis. I was given the choice of lumpectomy or mastectomy. Because I had had radiation before, I could not have it again in the same breast. (I didn't know that!) What followed was a heart-to-heart conversation with my doctor about the pros and cons of each. The keyword here is conversation. I wasn't told what I had to do; I was given options and recommendations. I knew that whatever surgery I chose, all indications so far showed that it should be non-invasive DCIS (often considered a pre-cancer now). I decided on a lumpectomy again. The results from the surgery were what I had hoped for—clean margins and it was the noninvasive DCIS.

The Next Step

Just recently I went in for my six-month follow-up mammogram and to see my doctor. Everything looked fine. (In fact, I was offered this assignment to write a first-person essay about my breast cancer experience literally the day I was at the doctor's office.) I knew that this check-up and mammogram would provide just a snapshot of my health at this moment and that things can change. I am not pessimistic, though—far from it.

In fact, when asked what advice I would give others facing cancer, I always say the same thing: be positive, be knowledgeable, be proactive, and make sure you have a say in your healthcare. Most importantly, surround yourself with those you love. Within a year before this latest lumpectomy, I had had two other cancer surgeries (not related to breast cancer). And each experience reminded me to love with reckless abandon. To me, it is the only way to move forward.

And as to the studies, the research papers, and the conflicting recommendations, all I can say is that I have to go with my gut feelings and the guidance of doctors that I trust as good partners in my healthcare.  I can't be sure where I will land (statistically) on the body of scholarly works regarding breast cancer, but I know that for right now I am doing great—living life fully, one day at a time.

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