10.17.2015

on 3-D mammograms

pink cosmos in canning jar

Okay, so my big news is that I don't have to have chemo after all, only a course of radiation and a lifetime of extreme hormone therapy, which in case anyone is wondering isn't for breast cancer patients about adding hormones but subtracting them because some of us have the kind of breast tumors that feed on estrogen and progesterone. Thank goodness for the latest European cancer studies wending their way across the Atlantic. So even though I don't carry the BRCA1 or BRCA2 gene mutations, I'll still be having another surgery soon, a prophylactic laparoscopic bilateral salpingo-oophorectomy, which means they'll be cutting out my ovaries and fallopian tubes. I never wanted children, anyway. Early sudden menopause, here I come. This may put me at other health risks, them cancelling out my body's hormones well ahead of time, but cancer is pretty much the biggest trump-risk of them all. The oncologist has also put me on a hormone blocker for extra protection, since the ovaries are the main but not the only producers of girly hormones. But why should random strangers happening upon the blog care about my cancer treatment saga, you might ask? Because no one would ever want to go through any of this, if it could be prevented.

So in light of October being Breast Cancer Awareness Month, for which I am personally right on time as a fresh "survivor," here's my big pitch: Get a 3-D mammogram every year, no excuses! Women who die of breast cancer are typically the ones who did not get regularly screened. And don't bother with the old 2-D ones. Tell any behind-the-times doctor or insurance company to stuff it and find a clinic, preferably a women's clinic, that offers 3-D mammograms as the standard breast diagnostic.

My younger sister, who lives in a small town in Idaho and who is now considered at heightened risk because she suddenly has a first-degree relation with breast cancer (i.e., me), had to spend a whole morning this week calling around her region trying to find some clinic offering 3-D mammograms. (Her doctor had already wanted her to have a baseline mammogram at age 37 this year, even prior to my own breast cancer diagnosis this summer.)

She finally happened upon a hospital in the Sun Valley resort area promoting their new 3-D mammogram system; insurance companies would be billed at the 2-D mammogram rate and then the hospital foundation would pay the difference between the 2-D and 3-D rates for the first 3,000 patients. Sadly, my sister will have a three-hour drive each way to and from her 3-D mammogram appointment, but at least she'll have it done. (Having the latest technology locally available is a huge benefit of living in a city compared to rural areas.)


Legacy Health 3-D mammogram promotional poster

Here in Portland, I consulted a billing specialist at the mammography center at my own hospital, Legacy Health, who suggested that women shop around for clinics who will split the difference like that. At my hospital, for example, the difference currently is only $82, well worth the extra cost for better screening technology. Mammograms may need to be followed up immediately, as in my case, with additional testing procedures like ultrasounds, biopsies, and MRIs, but mammograms are where diagnosis starts.

Please help spread the word. Breast cancer is increasing in younger women (below age 40), and one in eight women will be diagnosed with invasive breast cancer in her lifetime. Unfortunately, scientists can only list risk factors, still unable to explain what causes cancer—other than the general statement that environmental factors affect gene expression. So could the factors be excess stress or unresolved emotions? Is it a population increasingly delaying and reducing years of childbirth and breastfeeding? Might it be widened exposure to bovine growth hormones, hormones in certain birth control methods, or parabens or other estrogen-mimicking chemicals? Science may better piece together the cancer puzzle someday. Till then, all we have to hold onto are healthy diet, regular exercise, stress reduction, and early diagnostics.

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