Let us share the message of early breast cancer detection

I love breast cancer awareness month. As a medical doctor, it gives me an opportunity to spread the message of how important early detection is for improving the success of breast cancer treatment.

I am surprised regularly at the number of women who are either not doing mammography at all or who do it every couple of years when they remember. I know that women who are participating in annual screening mammography are patients, most likely to have their cancer detected at the earliest stage and subsequently have the best outcome. Except when they don’t.  

Imagine that you have been doing mammography faithfully every year. You are screened in a high-risk clinic with MRI or one of the advanced tools available. You had genetic testing done based on your family history and it turned out normal. And three months after your mammogram, you feel a mass in your breast. You call your doctor. Ultrasound. Biopsy. CANCER. Unfortunately, the type of cancer that pops up in the scenario is high-risk. You need chemotherapy, surgery, radiation. And after all that treatment, your cancer will still have significant risk of coming back or spreading.

Imagine that your cancer was detected early.  Stage 1. You were the lucky one. You had surgery, no radiation, no chemotherapy. You only had to take a pill. Years later, after breast cancer was barely a thought, a back pain that would not go away turned out to be metastatic breast cancer. Cancer has shown its ugly face again after all those years. Suddenly your luck seems to be running low.

Imagine that, at age 32, long before screening mammography is a part of your vocabulary or insurance coverage, your blood work shows abnormalities. It gets rechecked and shows no change.  You go for CT scans. A “little something” is in your liver. Then a biopsy.  And suddenly you have metastatic breast cancer. Before breast cancer was ever supposed to happen. Too early in life for early detection.

Imagine how standing next to a grocery store display of pink socks, and pink scarves and pink coffee mugs encouraging you to celebrate “the women in your life” can reduce you to tears if your wife, mother or sister died of breast cancer a few months ago.

Although data are yet to be actualised, statistics show hundreds of women die of metastatic breast cancer each year. For persons living with metastatic breast cancer, the cute slogans can be painful. “fight like a girl” seems to minimise your experience when you are fighting for your life. “Early detection saves life” is a painful message when you did everything right and still have metastatic disease. “Save second base”, jokes and cookies that look like breasts, don’t look very funny when you are not curable. A delicate pink ribbon can be embarrassing when you are a man diagnosed with breast cancer.

This October therefore, I ask you to share the message of early detection. To celebrate all the progress we have made treating and understanding breast cancer. However, know that there is still not a cure for everyone. And like in much of modern life, we need to try to understand that each of us has a different experience.

Some cancer survivors want to celebrate. Some want jokes. Others want to forget. Others simply can’t forget because the disease won’t let them. Take time to know the experience of those in your life.

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