The Early Bird Survives

October is Breast Cancer Awareness Month. But Be Aware Every Month

The eight little spots popped up quickly, no bigger than pinheads. I’d had a mammogram in August 2018, and the result was: All Clear. Then, less than 11 months later, I thought, “Let’s just get another mammogram because it’s time.” I was so proud of myself, because for once I was ahead of schedule.

Thinking nothing of it, I went for a common garden variety mammogram on a Monday, expecting another “all-clear” Tuesday. Instead I got a call saying, “Come back in, let’s do a biopsy.” A biopsy? Yup. Eight little manually undetectable spots had displayed themselves on the mammogram and they had to go. Stage 3 DCIS – Ductal Carcinoma in Situ – which is just a fancy term for “they haven’t grown yet, but are going to, so get ’em out now.”

And so, less than a week later, I was in pre-op getting ready for a lumpectomy. The surgery was way less traumatic than I expected. The experience was almost a non-event; I was back in Pilates four days later. I was also ordered to do a month of daily radiation treatments. I remember that the radiation technicians, all women, were wonderful and friendly, but had no sense of humor. As I lay there, arms above my head and seeing my reflection in the overhead mirror, I said, “So this is how I’m gonna look, stretched out on the morgue slab.” No one laughed.

While I displayed my angst with graveyard humor, others take it way more seriously. And they should, because one in eight women will be diagnosed with breast cancer this year, according to the American Cancer Society.

Coral Gables resident and retired teacher Dale Dowlen took her diagnosis in 2000 seriously. “I knew I was in trouble when Lon [husband Urologist Dr. Lon Dowlen] started reaching out to his medical colleagues for advice,” she says. Dale went on to have the whole series of treatments, including a mastectomy, chemotherapy, radiation and reconstruction. Dale thought she was free and clear, and she was until 2015 when another routine mammogram showed a tumor in her other breast. Again, she opted for a mastectomy and breast reconstruction, “I was grateful for my decision because a second, very early malignancy was removed,” she says.

The key for Dale was early detection, and that is all important for survival, says Dr. Felicia Knaul, Ph.D., who wrote the book, “Beauty without the Breast” (Harvard University Press, 2013) detailing her journey from diagnosis to survivorship. The directive “Do a monthly breast self-exam” has evolved, she says, and is now “Know your body” – look for changes and know yourself so well that when something is off, you recognize it and take action.

When Dr. Knaul was diagnosed with an aggressive Stage 2 breast tumor at only 41, the mother of two young children, she used her harrowing journey to make the experience less frightening and more hopeful for others. Her book has been a bestseller and an inspiration to thousands.

Now a professor at the University of Miami Leonard M. Miller School of Medicine, and a contributing researcher at the Sylvester Comprehensive Cancer Center, Dr. Knaul’s philosophy is not unique. But that doesn’t mean it’s any less important. “Your lifestyle is hugely important. Eating well, not smoking, exercising and avoiding obesity, that your alcohol intake is very moderate, all greatly reduce your risk of getting a breast cancer diagnosis,” she says. Currently Dr. Knaul is concerned because breast cancer diagnoses have plummeted 20 to 25 percent, which sounds good at first but, “just means fewer people are going to get mammograms during the Covid-19 crisis because they’re afraid of going to a medical facility.” She expects to see a huge spike in cases as the virus disappears.

Dr. Knaul’s message: “Our health systems have figured out how to be safe and how to keep us safe. Schedule your mammogram. They will protect you.” I can vouch for that personally, having gone to the Baptist Health Diagnostic Center on Giralda Avenue in August for a check-up mammogram. It’s a large facility, so social distancing was easy to maintain. Still, it’s uncomfortable, and it’s undignified. But it can save your life.

Katrina Daniel is a medical reporter who served on the Susan G. Komen Board for 10 years (2004 to 2014).

Dr. Felicia Knaul