Check your boobs, by Simone Kerr
Australian model model/dancer/designer Simone Kerr (pictured, above) describes what happened when she recently found a lump in her breast:
I must admit, as much trouble as they have caused me, I love my breasts. They make me feel feminine and like I have curves, even if that’s the only part of my ectomorphic frame that actually does curve! So when I was reading the newspaper as I waited for a flight from Perth to Sydney and I saw my image used on an article about augmented breasts I was indignant and annoyed, and slightly exasperated because I have been fielding these accusations for years. Not that it causes me any real inner turmoil, but for hopefully the last time, they are real, dammit! I sent an email to my agent and had a laugh about it with my girlfriends at the pub.
It was only twenty-four hours later that my breasts caused me real anxiety. Not because of the article, but because I was back in Perth, having a shower and absent-mindedly soaping up, recalling what a negative externality was for my upcoming microeconomics exam, when I found a lump.
I tried to find the matching lump in the other breast but to no avail. I decided I would wait to see what the doctor had to say before I really worried though. At 26, I thought, what are the chances of it being something sinister, really! So I Googled it. Big. Mistake. Article after article of worst case scenarios flew across my screen, so I flicked over to Google Scholar to get some more sensible and rational answers. I found statistics. I like statistics.
Breast cancer is the second most common form of cancer, after non-melanoma skin cancer. It is the second leading cause of cancer-related death in women in Australia. As of 2008 it was estimated that 159,325 Australians were living with breast cancer. The average age of diagnosis was 60.7 years. These figures are not something to scoff at and I realised that whether or not I was immediately being affected by it, either myself, or someone close to me would be at some point in my life.
The next day at the doctor’s, I waited anxiously and, since I couldn’t make my mind focus on exam preparation, I crushed candy on my phone instead. As soon as I was inside the consultation room I felt utterly ridiculous, because of my age she must think I am a hypochondriac of the highest order! My doctor was actually very sympathetic and reassured me that any lump should be checked out by a professional and not left to self-diagnosis from Doctor Google. She told me it was probably nothing but she would refer me to a radiologist for an ultrasound just in case. This was just the next step. I started to hear “probably nothing,” “just in case,” and “the next step” a lot over the coming few weeks. Medical practitioners sure have that poker face thing down.
This happened on a Friday, the last Friday of semester. I was booked in for an ultrasound first thing Monday, the first Monday of the study week. While the chances of it being something nasty were small, I couldn’t help but think about how nasty exactly that outcome could be. Would a mastectomy be next? That wouldn’t bother me. I would be proud to have augmented breasts and that aforementioned article would have been more prophetic than it could have realised. These thoughts clouded my brain. There simply was no room in my head any more for microeconomics or financial accounting. There never really was room for financial accounting, to be honest, so boring, but exam stress alone is enough to make me an anxious mess, let alone lumpy boobs!
The ultrasound was thorough and as the technician took ultrasonic images of my breast tissue I again witnessed the steely poker face. This did absolutely nothing to assuage my apprehension. The doctor came in to examine the images and informed me the lump was behaving weirdly on the screen. Awesome. I was informed that it was probably nothing, but to be certain they were going to perform a fine needle aspiration just in case, but not to worry, this was simply the next step. The appointment was made for first thing the next day.
As much as I tried to focus on studying and exam preparation, apparently worry was written all over my face. A good friend could see it at a fitting later that day and when I confided in her what I was in the middle of she admitted to me that she had not only gone through the same thing three times, she also carried the BRAC gene. Over the next few weeks I would encounter many women who had experienced the same thing. For the first time in a long time I felt the love and warmth of camaraderie of the sister hood, something that I had lost faith in a long time ago. Is this where the term Bosom Buddies comes from, I wonder?
I slept restlessly the night before the FNA. I hate needles; it took me six months to get a blood test after a doctor requested it and even then I had to be coerced into the chair and allowed to cry while I looked up at colourful exotic birds. So much for not worrying until there was actually something to worry about. The nurse distracted me with stories about her sock-stealing cat and just as I started to relax she bought out the comedically long needle. I laughed. I don’t know why, probably because it was too late to run.
I was informed that a Fine Needle Aspiration only takes a very small sample and sometimes the tests come back ‘indeterminate’ resulting in me back in the chair so they can take a larger sample. In light of this they were now going to perform a core biopsy; a slightly more invasive procedure but a more thorough one, just in case. The doctor asked if I was cold because I was shaking. I informed him that the room temperature was just lovely, thank you, I was just freaking out. The core biopsy was performed under a local anaesthetic, the only really painful part of the procedure, for me anyway. The nurse’s crushed hand is another story. The large needle was inserted into an incision made by the doctor and guided by the ultrasound image. I heard a clicking sound and felt pressure like a wet towel flicked my boob as the sample was taken. The moment I began to relax because the needle had been removed, I was told that this must happen at least four more times to ensure a big enough sample is taken. Just in case.
Feeling slightly butchered and looking very bruised, my bra was stuffed with tiny ice packs and I was left to wait for the results. As if exam time wasn’t stressful enough, I couldn’t help but ponder what would be the next step, just in case? Lumpectomy? Mastectomy? Radio? Chemo? Would my breasts, that were my ‘Money Makers’, kill me? Just like my emotions, my left breast had gone through a kaleidoscope of colours and was now a dark blue-black. A week later, two university exams down and I got the results. No malignancy. I am now required to have yearly ultrasound scans and more consistent at home examinations. I received the news at work and my makeup had to be touched up on set because the relief overwhelmed me.
While I received good news, that is not the case for many women and it has all happened at a rather topical time too. As Amy Robach of Good Morning America announces a live mammogram ‘has saved her life’ by detecting breast cancer and must now undergo a mastectomy, The Today Show’s Lisa Wilkinson has pledged to do the same thing in order to raise awareness about the importance of early detection. It remains to be seen whether it was in fact ‘early detection’ and it may be years before we know it saved Robach’s life, according to Pink Ribbon Blues, an organisation that believes breast cancer culture is undermining women’s health.
Good Morning America however have omitted the fact that universal screening does not guarantee early detection of the most aggressive cancers. In a study conducted by German doctors, it was found that mammograms were not enough to effectively detect the most aggressive cancers in the most favourable stages. They found only a 49% sensitivity of mammography and ultrasound combined, compared to a 91% sensitivity of MRI scans.
Breast cancer is as complex as it is deadly and terrifying and even though it is extremely important to detect it early, the most popular diagnostic tool has limitations. When I asked why I wasn’t having a mammogram I was told it isn’t very effective in younger people because they have denser breast tissue and until this experience I had no idea it could be detected in any other way. As doctors are able to better characterise the biology of this disease over time, better screening will emerge with it, increasing the accuracy of diagnosis and lowering the incidences of overtreatment, something that has resulted from the blanket message of universal screening. I encourage anyone concerned about a lump to get it checked out. It isn’t pleasant, however having a biopsy means I know for sure what it is or isn’t. The doctor said at the ultrasound it was probably nothing but did the biopsy anyway to be 100% certain, and my mind is now at ease.
I have added annual ultrasounds to my list of medical checks and I now have an excuse to be ‘handsy’ with the girls. It might just save my life. Hopefully my uni exam results are as good as the core biopsy results, but I am not even worried about those. Just glad it’s over.
Update: I received my university results. Two distinctions and two high distinctions.