Yesterday was Veteran’s Day. I celebrated by having a mammogram (as an aside, I’m profoundly grateful for the men and women who fight for our freedom).
I’m 31 and that’s fairly young to have regular mammograms.
I started when I was 25.
My mother had breast cancer and nearly two decades later she had ovarian cancer. She survived. It’s quite possible that she was BRCA positive, but I’ll never know for sure (THIS, in part, explains why).
When I learned she had ovarian cancer, my doctor strongly suggested I be tested for the BRCA gene mutation.
A mutated BRCA gene prohibits genes from staving off cell growth. In other words, instead of fighting off certain cancers, it’s opens the door and says, “Well hello there. Come in” (I don’t actually know if the little mutated bastards are that nice, but I do know that they don’t do what they’re supposed to).
According to the American Cancer Society, women have a 12 percent chance of developing breast cancer in their lifetime. A woman with a BRCA gene mutation has a 60 percent chance. Additionally, a woman has a 1.4 percent chance of developing ovarian cancer over the course of her life. With a BRCA gene mutation, the risk goes up to 40 percent.
In 2011, an estimated 22,000 women will be diagnosed with ovarian cancer. 15,000 will die. That’s a nearly 75 percent death rate.
At 24 those statistics were very real to me; I decided to undergo the genetic testing and I was terrified. The test is outrageously expensive and waiting for my insurance company to approve it was maddening.
Once the testing was finally approved I needed to complete the first stage– a consultation with an oncologist and a genetic counselor.
I went alone to my appointment because my husband was home with our two young children. I was hoping it would be quick since I was still nursing my daughter and didn’t want to be gone long.
The oncologist was kind, but I wasn’t diagnosed yet and I had both my breasts and she had other patients who needed her more than I did. She spoke to me as she did a breast exam. I warned her that I was nursing and she said it wasn’t anything she hadn’t dealt with before. She went over numbers and death rates. She finished up by asking me what I’d tell the insurance company if my BRCA testing came back positive.
“I don’t know,” I said.
“Oh yes you do,” she replied. “You’ll tell them you’re going to have a double mastectomy and oophorectomy.”
I was stunned.
Tears fell into my hair and as I sat up I felt them fall to my lap. That’s when I realized I was leaking breast milk. Everywhere. I laugh at this now, but at the time, not so funny.
I was 24 with two young children and I was told that in mere weeks I might have to decide whether to remove my breasts and ovaries. From the perspective of the doctor, it wasn’t even a choice. I dressed, rushed to my car and sobbed.
My tests came back negative.
Scientists know more about the BRCA gene mutation now; my negative results don’t mean anything without knowing whether my mother has the gene mutation also.
Consequently, I’m not in any better position than I was that day at the doctor’s office.
So that is why I began having annual mammograms when I was only 25.
As I sat in the waiting room yesterday I watched the seats fill up. There were women who flipped idly through magazines; just a routine check-up, I decided. There were women whose knees bounced and some who wouldn’t make eye-contact; I let my mind create back stories for these women, and my heart hurt.
There was one man, sitting alone, facing the door leading to the x-ray rooms. He held a small purse on his lap (I was sure it belonged to his wife because it didn’t match his outfit). He looked to be in his 50s. He was wearing a mechanic’s shirt. He hung his head low and turned the purse over and over in his hands, fingering the stitching. He looked up expectantly every time the door opened, only to drop his gaze to the floor when a stranger walked through.
“Please God let his wife be okay,” I said to myself.
The air was thick with silent prayers and I was relieved when my name was called.
My technician was nice. She had the accent of a New Yorker, veiled by years of living in California. She is a nana, she told me, and can’t wait for Christmas so she can buy her grandson gifts.
She did her thing, and I went along for the ride.
Her constant gentle directions were spoken from rote memory…
step forward now put your arm up there no the other handle i’m sorry if this hurts shoot my hand is stuck in there come toward me turn your head hold your breath don’t move i’m sorry again turn your shoulder we have to get as much tissue as possible.
When I was through, I half-listened to her as I watched my breast in ghost form creep onto the screen. I looked at a spot I hadn’t noticed in my past scans. “I like your earrings,” my technician said as she stepped between me and the image, blocking my view.
I wonder if she noticed my eyes narrow, accusingly. No doubt she was simply trying to keep me from self-diagnosing.
“Everything looks great,” she said. “The radiologist will review the scans and let you know if you need any additional tests.”
“You’d better be right,” I thought to myself. “I want to be someone’s nana too.”
I think back to that scared girl sitting in her car sobbing at the thought of losing her breasts and ovaries, and I almost don’t recognize her.
Maybe it’s what happened when I matured out of my 20s or because I’ve had two more children since that day. We’ve moved a few times. My kids are in school now. Whatever the reason, I know my choice now would be simple.
Take it all. Who cares. If it lowers my risks, if it lengthens the time I can spend with my children, my husband, then who cares?
I ache at the thought of cancer taking me before I can watch my daughters walk down the aisle or see my sons hold their babies.
So every year, when I go in for my mammogram I wonder if it will be the year that they find something.
And every year, as I watch the women, full of fear, sit in a waiting room to find out whether they have cancer or whether it’s back or whether it’s gone, I wish for a tiny second that my tests were positive all those years ago so that I wouldn’t have breasts to worry about.
But in the end, it’s out of my hands and that’s the only part of the whole deal that brings any peace at all.