“At the end of the day, we can endure much more than we think we can.” — Frida Kahlo
October is here which means not only great fall weather, the Chicago Marathon, and my industry fertility ASRM meeting, but it is also breast cancer awareness month. Pink ribbons have taken over football, the airport, and line the side of taxi cars. It seems you can’t look anywhere or turn on the TV without being bombarded with these pink messages everywhere. It wasn’t that I was not aware of breast cancer awareness because I’m ultra aware of how it is breast cancer awareness month…but this year, October is taking on a whole different meaning. I work in the industry and help clinical trials in breast cancer. I have several really good friends that have survived breast cancer and sadly too many other dear friends who have passed after battling the disease.
What is different this October is that I learned this month that I have dense breast tissue. I found a small lump in my right breast the first week of October when I was traveling to Denver for my annual fertility meeting. I got very emotional about this discovery because I have been helping clinical trial research in breast cancer and have been apart of many surgeries over the last few years helping women who have been diagnosed. Initially I was scared I would hear that I had the “C” word and be forced to join the cancer club along with so many friends. Honestly that was the last thing I felt like I could handle or want to fight given all the challenges of 2018 thus far.
I had heard about what dense breast tissue was many years ago and didn’t think much about it. I had even worked with others helping sell equipment to aid in screening or diagnosis for patients with dense breasts. The medical description of dense breasts is described as the relative amount of these different types of breast tissue as seen on a mammogram. Dense breasts have relatively high amounts of glandular tissue and fibrous connective tissue and relatively low amounts of fatty breast tissue. Dense breasts are very common in younger women, women with lower index body fat, or if you are taking hormone therapy for menopause.
What does it mean to have dense breasts? Having dense breasts increases the chance that if breast cancer is present it may go undetected. Dense breast tissue makes it more difficult to interpret a mammogram, since cancer and dense breast tissue both appear white on a mammogram and imaging. Women with dense breasts, but no other risk factors for breast cancer, are considered to have a higher risk of breast cancer than average though doctors aren’t certain why. Most medical organizations recommend women with an average risk of breast cancer consider regular mammogram testing beginning around or before the age of 40 years old and consider repeating the screening annually.
After I got back to Chicago, I went in for the first appointment I could make for a mammogram. I wasn’t scared to get the mammogram and ultrasounds tests done, but rather more nervous what the imaging results would say about what I thought to find and feel in my breast. Was I making it up in my head? Did I just imagine this lump? Am I crazy? Is this why my boobs have been tender or hurt recently? Is this why I have been getting adult acne and weird hormone fluxes? What is this going to cost me? How much is my insurance going to pay or not pay for these likely pricey imaging exams? I have got to be too young for cancer right? It doesn’t run in my family that has to be a good thing. How likely is this a fibroadenoma or cyst? These were just a sampling of thoughts running through my head as I stepped into the breast imaging center. I was so thankful for the kind and smiling staff that helped me fumble my way through the paperwork and authorizations.
After all of my imaging exams were taken I was told I indeed have a lump, but it was likely 99% benign. It was also explained to me that I had dense breast tissue. I was told I could get a biopsy done any time. There’s some evidence that additional tests may make it more likely that breast cancer is detected in dense breast tissue. Here are some other additional or supplemental testing you could opt in for.
- –Hand-held Breast Ultrasound: Ultrasound uses sound waves to analyze tissue. A diagnostic ultrasound is commonly used to investigate areas of concern discovered on a mammogram but depends on the technologists doing the exam.
- –Breast MRI: MRI uses magnets to create images of the breast. MRI doesn’t use radiation. Breast MRI is recommended for women with a very high risk of breast cancer, such as those with genetic mutations that increase the risk of cancer.
- –Automated Whole Breast Ultrasound: An automated whole breast ultrasound like SonoCiné AWBUS uses sound waves to analyze tissue over whole breast at the same time for a complete diagnostic view which provides a consistent, repeatable scan of the whole breast including the axilla underarm and lymph nodes.
Ask your doctor to take a closer look and tell you the difference between fatty breast tissue and dense breast tissue. You have to be your own advocate and take responsibility for your own breast health. Self breast exams are good idea to do at least once per month. Did you know studies show women with Dense Breast Tissue and women with implants need an additional exam such as an Ultrasound or MRI. They can find more and smaller cancers than can be detected by mammography alone. It is only mandatory in a few states that your doctor disclose to you that you have dense breasts.
Check out cancer survivor friend Jeannine Canino Bieda‘s story about her breast cancer diagnosis, egg freezing, and embryo freezing decisions. She was recently also featured this month in WGN’s Stories of Hope segment raising awareness for dense breast tissue. Jeannine has been a huge support system for me during this uncertainly of my own journey.
Read here how my Eggology Club podcast voiceover artist talent Shannon Holly got her first mammogram and talked about it. I learned later we actually got a mammogram for the same reason (felt a lump) and on the same day. If she can be brave to talk about this topic on the radio new 102.7 in New York, then I knew I could be brave enough to share my experience too.
I want to also thank Dr. Andrea Madrigano at Rush University for getting me into my mammo appointment so quickly, Dr. Bob Maganini and his team at AMITA St. Alexian Brothers for the whole breast ultrasound, Dr. Barb Schwartzberg at Rose Medical Center who consoled me over the phone while in Denver, my dear friends Chiqeeta Jameson, Marlene Belmonte O’Connor, Rachel Fisher, Colleen Gubbins, and my sister Crystal for their support, late night texts, and phone calls over the last few weeks checking up on me as I fretted about what this palpable mass was.
This all makes me super thankful that I froze my eggs several times in the past. It is also making me feel like I want to freeze one more time. If I was facing the realities of cancer, I would also have to deal with protecting my future family. Even though I have 29 eggs currently in the freezer, I have not thawed any of those eggs or tried to make them into embryos yet. Anything can happen or it is possible they do not work. All of this has brought a new meaning for “eggtober” for me.
The updates and changes in access to care recently have been improving. Luckily for Illinois residences (and a handful of other states like Connecticut which was the first to change the regulations) the new recent legislation passed to provide full treatment coverage for anyone faced with a life threatening illness that could effect their fertility. Melissa Thompson has been leading the charge for this mandate of fertility care to help cryopreserve eggs, sperm, and embryo creation. Melissa has bravely not only survived breast cancer, but has successfully created change in state governments for adopting these supportive bills. To learn more about Melissa and her incredible mission and work check out her website melissathompson.com.
What is next for my situation and fibroadenoma is a 6-month follow up and a future biopsy to confirm qualification for the Novilase laser ablation and national ABLATE registry trial. The Novilase device was recently FDA cleared for the United States and soon to be CE marked in Europe. I worked for several years on this project and research. I always said that if I was a candidate or needed a tumor to be ablated I would use Novian Health‘s technology for my treatment options. I am so thankful this technology exists for the option to choose and use it. For a visual on how the Novilase laser ablation procedure works, you can watch this animation video.
Wondering if you have dense breasts? Have you scheduled your mammography this month? Have you been diagnosed with breast cancer? Not sure where to turn? Check out these helpful charities and organizations.
Thank you for sharing your important story! Most women have no idea if they have dense breasts or not. It should be made mandatory to inform women of their breast tissue types! I was told early on that I had very dense breast tissue. I always had lots of cysts and one biopsy that was found to be a fibroadenoma in 2006.
Unfortunately, in Dec 2014, my mammo showed clustered micro calcifications. The breast radiologist said a bx was necessary b/c of the cluster formation. It proved to be ADH – atypical ductal hyperplasia (pre-cancerous abn cells – and an excision (like a lumpectomy) was scheduled for 1/20/2015.
My breast surgeon thought it diligent to check a breast MRI since I’d never had one, and my mom and 2 half-sisters had had breast ca. It was a “dotting the i ‘s and crossing the t’s” kind of a thing.
Well, thank God she ordered that MRI. It detected a completely separate, not connected to the ADH, mass deep in my left breast that ultrasound and mammo did not even show. ANOTHER biopsy later, it was diagnosed as Invasive Ductal Carcinoma, stage 2B.
On Jan 20, 2015, I had a bilateral mastectomy and the beginning of a long and arduous reconstruction due to repeated infections of the Right tissue expander. I finally finished reconstruction (implants) one year later, January 2016.
If breast cancer runs in your family (you don’t have to be BRCA + because there are many other familial breast ca genes plus many more yet to be discovered), and your breasts are dense, I cannot emphasize enough the importance of the Breast MRI!! It very well may save your life.