The little ball of fear that had been sitting in the pit of my stomach for a few weeks vanished when I read the letter.
"I am pleased to inform you that your mammogram was found to be NORMAL," said the letter from my regional health authority.
Well, phew. I don't have to worry about breast cancer until my next mammogram in two years. I was so relieved that I announced the news to my family at supper. High fives from my husband and two daughters, then aged nine and 12.
The letter stated that mammograms aren't foolproof and encouraged breast self-exams, but it left out a crucial bit of information that could have cost me my life.
It turns out that I am one of the nearly three million Canadian women over the age of 40 who have dense breasts. The letter did not tell me that. Nor did it tell me that because I have dense breasts, I have a higher chance of developing breast cancer and that it will be harder to detect on a mammogram. Mammograms miss more than 50 per cent of the cancers in the densest breasts.
While I went on living my life, a cluster of aggressive cancer cells that could not reasonably be seen on the mammogram was multiplying in my left breast. I found the cancer on my own by accident about five months later in November 2015, when I stayed at a hotel that didn't have those shower puffs I use at home. My soapy hand grazed over the underside of my breast and there it was — a lump just a bit smaller than a golf ball.
I've been to hell and back since then — breast surgery, 16 rounds of chemotherapy, six weeks of radiation and now hormone therapy. Rarely a day goes by that I don't think about what would have happened if I didn't go to that hotel without the puff. What if I didn't find the lump for another several months and the cancer had spread to my lymph nodes and bones? Would my daughters be paying tribute to their dead mother by writing my name on the back of their shirts at the Run for the Cure?
You can't tell how dense breasts are just by looking at them, by their firmness or their size. Only a radiologist can determine breast density by looking at your mammogram. Forty per cent of women over the age of 40 have dense breasts, yet most have no idea that they have dense breasts or what it means.
Instead, they get the form letter like I did — a letter that gives them a false sense of security.
How come women know so little about dense breasts? Because — astonishingly — no province in Canada shares the information directly with women. Each province differs on how, OR IF, it reports breast density to doctors, who may or may not tell patients. In the New Brunswick community where I live, information about breast density is usually recorded on mammogram reports, but patients don't see those unless they ask for them. Instead, they get the form letter like I did — a letter that gives them a false sense of security.
Knowing that I had dense breasts may not have prevented me from getting cancer, but I would have been more diligent in monthly self-exams and would have talked to my doctor about how I was screened and how often.
High breast density is, in fact, a greater risk factor than family history. Yep, you read that correctly. We all know how much women stress about lumps if breast cancer runs in the family; yet countless women don't know anything about their breast density until it's too late. Far too many women find their cancer at Stage 4 when it's incurable — a fact that often gets lost amid all these feel-good, pink breast cancer campaigns.
On average, 72 Canadian women are diagnosed with breast cancer every day. Why, why, why aren't women being alerted to one of the biggest risk factors? It's akin to not telling them they have high blood pressure that could cause a heart attack. How can women mitigate a risk they know nothing about?
We can do better. Canada needs to overhaul how women with dense breasts are screened for breast cancer. The first vital step: alert these women that they have dense breasts and tell them what that means. The regional health authority in my community just needs to add a few lines to the letters already going out to women after their screenings. It's a simple step that could save lives.
Since unfortunately that's not likely to happen anytime soon, women need to know this: Your breast density matters. You need to be your own breast health advocate. Ask about your breast density, be vigilant with your self-exams and talk to your doctor about what screening methods are right for you. I'll never know how earlier detection would have changed my treatment or prognosis. I do know this for certain: If I had known I have dense breasts, I would not have left my breast health to chance. And take it from me, neither should you.
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