Why I'm NOT Getting a Mammogram this Year, But Why You Should!
I'm not getting a mammogram this year. Did you know that once you've had a bilateral mastectomy you have nothing left to test? Last October, I went for my annual mammogram. I had been going every 6 months until last year because I have those dense boobies. Plus my mother also had breast cancer. Last year the radiologist gave me a reprieve and said it is all the same stuff, so let's make it a year. Well, what a difference a year makes!
On October 17, 2019, I was diagnosed with breast cancer from my mammogram and then an ultrasound in the same visit.
Cancer was confirmed the next week by three, yes three, biopsies on my right side. Many appointments followed with general surgeons, more radiologists, plastic surgeons, oncologists, radiation oncologists and a geneticist. I am a Virgo, so I felt an incredible need to be systematic, thorough, diligent, and persistent about my diagnosis especially since I could not control the situation.
I did pose the question, "Are you sure my left is clear?" Call it women's intuition, but I had a feeling. Sure enough, I had a breast MRI prior to my surgery which is typical, and of course, I also had a tumor on my left. My boobs were officially declared a disaster zone. On December 4, 2019, I had a bilateral mastectomy with expander placement and bilateral axillary node dissections. The final pathology reports read 5 tumors on my right and 2 on my left, but thankfully, my lymph nodes were clear. Crazy, crazy lucky. Even luckier, I had the "good" kind of breast cancer. ER/PR + (Estrogen and Progesterone positive) and HER 2 Negative. Even with my mother's history, my genes did not have any breast cancer markers. I had already been genetically tested twice before my diagnosis, which were negative. This third time they sequenced not only my DNA but also my RNA, both negative. I recovered from my first surgery over the next 3 months, started on Tamoxifen, returned to work just in time for COVID 19 and had my final surgery May 5, 2020 to exchange the awful expanders for my new permanent perky boobs!
There's nothing like personal experience to make you a better physical therapist. I've had my fair share of injuries through the years that have taught me a lot about back pain, carpal tunnel, SIJ dysfunction, TMJ, whiplash, etc. I've treated many cancer survivors through the years, but now I have a brand new perspective. I've learned many things through my diagnosis, recovery and survival over the last year, so I thought I might share a few.
1. Mastectomies are not for wimps!
The recovery was hard. I'm so lucky that I had previously treated so many amazing women with breast cancer, so I knew what gear to order prior to surgery and knew what exercises to do and when to start them.
2. It is never too late to ask for help to recover from cancer surgeries and treatment.
PT isn't always at the forefront of physicians' minds. Even I had to ask for it, and I'm a PT. PT's who treat cancer survivors have tons of tricks to help with recovery, manage the effects of radiation, treat lymphedema, help with the effects of chemotherapy, and restore function. Go ahead. Ask for it.
3. Exercising regularly really does help manage depression.
One of the most common side effects of taking Tamoxifen is depression. My oncologist prescribed Effexor, but I couldn't handle the side effects. So, I exercise! I make sure to get at least 45-90 minutes of cardiovascular exercise per day. M, W, F I sit on a spin bike for 30-45 minutes. T, Th, Sat I run (for my life and personal sanity) for 45-75 minutes. I run the same distance but I'm much slower these days. Sunday I walk for 60-90 minutes. All of this not only helps keep me sane, but also helps me keep my weight down which is important as a breast cancer survivor.
4. Lymphedema can happen anywhere along the way.
So far, my lymphatic system is still working, but anytime they take lymph nodes out (7 on my right, 5 on my left), you must be careful. I wear long gloves when I'm in the garden. I dry brush my node areas to stimulate the system. I also stretch my chest and shoulders every day.
5. Cording (aka Axillary Web Syndrome) just happens and is often a side effect from axillary dissections and/or biopsies.
Again, I'm lucky to have treated cording in other women because I had a lot of it. You treat it by snapping and stretching the long bands of tissue that form from the chest wall down through the arm, sometimes to the elbow, sometimes all the way to the wrist and fingers. Cording limits shoulder, elbow and full arm range of motion and can be really painful. The sooner you treat this with physical therapy, the better!
6. Breathing exercises do help!
I still do my exercises every day. All kinds of breathing in many positions. Plus deep breathing and prayer seem to go together for me. Both help.
7. My pectoral muscles will never be as strong as they once were.
My implants are under my muscles (sub pec), so the muscle no longer has fixed attachment to my chest wall. Maybe I could get stronger, but it feels super weird to have my boobs move so much when I contract anyway. I guess I will just stick with my "girlie" push ups on my knees.
8. Although cancer survivors are typically grateful for finding and treating the cancer, there's always a bit of doubt that lingers and questions persist.
Did they get it all? Will it come back? When will it come back? Only time from the initial diagnosis gives you confidence that you are still in the clear. I'm officially one year out! Yay!
9. I try to improve my odds of recurrence by minimizing alcohol and keeping my weight down.
Both are correlated to recurrence in breast cancer.
10. I no longer receive mammograms because I no longer have breast tissue to examine, but you should.
I never felt any of my 7 tumors. Neither did my doctors until after the biopsies. They caught mine "early" because of the mammogram. Call to schedule yours today.
So in honor of Breast Cancer Awareness Month, go get your mammograms! If you have any friends or family members who have survived or have been recently diagnosed, please share this information with them. If you have any further questions about my journey, how PT can help, or how to navigate the diagnosis, please email me at firstname.lastname@example.org
- Thank you to my family and friends who supported and care for me through this journey.
- Thank you to my physicians at Scripps and UCSD for diagnosing, treating, and hugging me when I needed it. You are an incredible team.
- Thank you to my staff who rallied to run the clinic when I was out on medical leave and nurtured me as I recovered. You are all amazing.
- Thank you to all my prior breast cancer patients who taught me so much along the way. You are all so brave.