October is right around the corner, and for some, that means it's time to throw on a sweater, break out the spooky decor, and sip serenely on a PSL. Others of us are bracing ourselves for the pink barrage that accompanies Breast Cancer Awareness Month. A full 31 days of ribbons and races and rah-rahing.
Though well intended (for the most part), the abundance of pink is not always so rosy. Companies who have no ties to any charitable foundations profit heavily off everything from socks to drinkware to t-shirts, and more. Those who have lost loved ones or are currently enduring a heavy diagnosis aren't necessarily comforted by the often-celebratory tone of events that occur during the month. And, for all of the so-called awareness that's being raised, there are still many things the average person doesn't know about the disease. That's what I'm here to write about today.
There are many types of breast cancer.
It tends to get lumped all into one, but breast cancer comes in many forms and it's driven by a variety of factors. There's ductal or lobular, which describes which types of cells it originated in. It can also be in situ (localized) or invasive (having spread to nearby tissue). It can be fed by estrogen, progesterone, and/or the human epidermal growth factor receptor 2 protein (HER2). One can be positive for a combination of these, or all three (triple positive), or none of them (triple negative). Certain types are more aggressive and more difficult to treat than others.
The BRCA1 and BRCA2 gene mutations can come into play, as well. And, there are stages 0-IV, which identify how much the cancer has spread. Mine is invasive lobular, ER/PR+, HER2-, Stage IV de novo, by the way.
I'm sure I haven't touched on everything, but you can learn more about the different types here.
Dense breasts need more diligence.
If you've ever been told you have dense breasts, it's a signal that you may need supplemental imaging. That's because, for one, dense breast tissue makes cancer cells more difficult to detect. In some cases, such as my own, a tumor—especially lobular—can mimic dense breast tissue. In others, the dense tissue can simply obscure a tumor. Either way, this can allow one to grow without being seen during a standard screening. Having dense breasts also increases breast cancer risk, though it's not a guarantee that cancer will ever develop.
All of this is to say: You may have to get pushy to get proper imaging. If your doctor dismisses you, get a second opinion. Whatever you do, don't give up.
Having metastatic breast cancer (MBC) doesn't necessarily mean the patient was negligent.
I'm sensitive to this because I have MBC and it was diagnosed as such from the get-go. Yes, I was behind on my yearly mammogram, but the reality is, my tumor needed years to grow to the seven-centimeter size it was when it was removed. There were signs my body had exhibited that were met with shrugs. There was flippancy from my primary care team about the need for 3D imaging. As I've noted before, even after receiving a comprehensive ultrasound, the tumor was barely evident. Mine is just one story, but there are many others with different stories, and few of them have any correlation to what was or wasn't done, right or wrong by the individual. A bit more on this myth here. (As it pertains to MBC, the whole article is quite informative.)
About 30% of all earlier stage breast cancers will go on to become metastatic.
My goal here is not create fear or burst anyone's pink bubble. It's to say: Don't get too comfortable. You can be deemed cured and have a recurrence—and it can happen even decades later. You can have spread that isn't noticed or can't be seen. Stay up-to-date on your mammograms, maintain a collaborative relationship and regular appointments with your cancer treatment team, and don't ignore new pains or abnormalities. Trust your gut if something feels off. And, as I said above, if you experience medical gaslighting, persist. Don't feel inhibited to challenge your care provider; your efforts could save your life.
Because ... MBC is how people die from breast cancer.
Remember, screening is not prevention.
This may sound like an obvious statement, but it was an a-ha for me when someone else in my support group said it. Mammograms and advanced imaging are tools for early (or any) detection, but that's all they do. That's not to say they aren't important. After all, cancer that's found in earlier stages is easier to treat.
There's more, I'm sure. I'll admit that even though I am pretty intimate with much of this information, it makes me nervous to present it as the be-all-end-all. I encourage anyone looking to expand their knowledge about breast cancer to explore cancer.org's extensive breast cancer section. METAvivor.org is also a great resource for data, patient support, updates on research and trials, and more.
If you want to read about my experience, you can find the entire West Michigan Woman series here.
I also collaborated with fellow members of a Michigan MBC group on a soon-to-be published article in the upcoming Oct/Nov '22 issue. Watch for that coming soon.
Allison Kay Bannister has been a West Michigan resident since 1987 and a professional writer since 2002. A GVSU alumna, she launched her own freelance writing business in 2017. Allison is a cookie connoisseur, word nerd, aspiring gardener, and metastatic breast cancer thriver who loves traveling in Michigan and beyond, and enjoys art, world cuisine, wine, music, and making homemade preserves.