Letter to the Pennsylvania Breast Cancer Coalition

I received a letter from Sarah, a spokesperson for the Pennsylvania Breast Cancer Coalition, which is a very active organization located in Harrisburg, PA.. (I receive this organization's monthly newsletters, and I participated in the most recent conference, held in October, 2009). Due to the recent "changes" proposed in breast cancer screening, specifically, delaying initial mammography until age 50 and discouraging Breast Self-Exams, Sarah's letter had encouraged breast cancer survivors who were diagnosed in their 40's to share their stories and their reliance on mammography screening. Please read what I wrote to her regarding this issue:

Dear Sarah,

I am a breast cancer survivor. Here is my story.

At the age of 43, I felt a very small lump in my left breast, specifically under my left armpit area. Initially, I was not very concerned about this finding because I have a history of fibrocystic breast changes, and I believed that this lump was just another one of those benign, small nodules. But I visited a general surgeon just to be sure, in November, 2005. Her exam and palpation of the lump were inconclusive at that time. She recommended that I have my annual mammogram, which was scheduled to take place in January, 2006. The mammogram report acknowledged the lump, but again, the radiologist was unable to confirm that it was malignant. I then underwent an MRI scan which was also unclear, in January, 2006.

It was only after the biopsy was performed in February, 2006, that a definitive diagnosis was made: Stage 1, Grade 3 (the most aggressive rating) malignant breast cancer. The biopsy also showed that the cells were HER-2 Positive, poorly differentiated and extremely aggressive in their make-up. If left unchecked, the cells would have very likely spread quickly to other organs, and most likely, death would have been the result.

I underwent a left breast lumpectomy, 15 months of chemotherapy and Herceptin, and 33 daily radiation treatments at age 43.

I have no family history of breast cancer or any other type of cancer. I'm not at all obese, I've been an active runner for ten years, and I've followed a low fat diet for nearly 30 years. The news came as a complete shock to me, my husband, and our children who were 15, 9 and 6 years old at the time of my diagnosis. Simply stated, I have no risk factors, except that I am a woman.

I am quite certain that if the new "mammography screening guidelines" were in place today, I would not be alive to write this letter. If women are instructed to wait until age 50 to have mammograms and are discouraged to perform Breast Self-Exams, I feel that their lives will be in grave jeopardy. I am concerned that women will put off having mammograms, or simply forget whether or not it is their time to have one, if the recommendation is relaxed to "every other year mammography," as it is proposed. For many women like myself, waiting until age 50 for initial mammography screening is a death sentence. If this proposal is passed, breast tumors that could have been treated early will have become much more invasive, resulting in more lives lost and more children left motherless.

Early detection is crucial. Mammography and self breast exams are key elements in early detection and prompt treatment.

Please consider this letter a heartfelt plea to keep mammography screening at age 40 and earlier for women at high risk. Please continue to encourage all women (and men) at all ages to perform monthly breast exams. The risk is just too great.

Sincerely,

Karen L. Holmes, R.N., M.S.N.