To why haven't you had a mammogram yet?"
The question lingered for a minute in the chill of my new
gynecologist's office while I tried to come up with something other
than "because I'm terrified."
After stuttering something about having had a baby and putting
it off, she told me it was time to get it done. The staff is pretty
wise at this doctor's office. The nurse faxed the order for the
test right to the hospital's scheduling center, leaving no chance I
could stuff the order in my purse and watch it slowly erode into
pieces from spilled juice and melting M&Ms.
Those three weeks waiting for test day-and the subsequent few
days waiting for the results-were an interesting and sometimes
frightening odyssey. I was forced to think about things I was good
at shoving aside while juggling four kids, a husband and a job.
The one unavoidable cold, hard fact is that we all know someone
who has been affected by breast cancer. There are the famous-Sheryl
Crow, Melissa Etheridge, Kylie Minogue, Olivia Newton-John, just to
name a few-and the not-so famous. It could be your neighbor or the
mother of your child's classmate or the woman whose face you see on
a flyer for a benefit to help pay her medical bills. Almost always,
those women are shown with their kids.
In my own life, my mother-in-law was diagnosed decades ago in
her mid-30s, with two young boys to care for and at a time when the
odds of survival were stacked against her. She's a healthy woman in
her 60s today, but the scars still linger, both visible and
According to the American Cancer Society, breast cancer is the
most common cancer among women, except for non-melanoma skin
cancers. The chance of developing breast cancer is about 1 in 8.
About 178,480 new cases of breast cancer will be diagnosed among
U.S. women this year.
There are some theories about prevention, such as cutting down
on fat and exercising more, but even the healthiest woman can be
hit with the disease. While it is not perfect, mammography is the
most predominant screening tool for breast cancer and, most
importantly, it does save lives.
The American Cancer Society officially says women should begin
getting screening mammograms every year, beginning at age 40. The
American College of Obstetricians and Gynecologists goes a bit
further, recommending that women undergo at least one baseline
screening mammogram between 35 and 40, which is where I fit in,
then annually at 40 and older. Illinois law mandates that insurance
pay for the baseline screening between 35 and 39 and annual
screenings at 40 and older.
So knowing without question that early detection is the best
chance at survival and that a mammogram is the best chance at early
detection, why are so many of us so scared?
For me, the answer was the most irrational one possible: "What
if they find something?" Yes, I know (and my husband reminds me
often) that it would be better to find "something" now rather than
later. But I come from a long line of people who believe what you
don't know won't hurt you.
The truth is, I knew I had to get the mammogram.
As moms, we have a responsibility to take care of ourselves, not
just our families.
At long last, the day of my mammogram arrived. It was strange
for me to be going to a hospital for something not baby-related.
With 10 years of ultrasounds, blood tests and four deliveries
behind me, it seemed like I entered a new chapter of my life.
I did not do anything special to prepare, except quit drinking
caffeine the week before the exam. Some doctors say it doesn't
matter; others say it can cause you to retain water and show false
positive results. I wasn't taking any chances.
I checked in and was led to a changing room with lockers for my
clothes. When I put on the gown and walked to the next waiting
room, I noticed an Arab woman and her daughter waiting together. We
gave each other the same knowing smile, and I thought to myself
that here is one place where women are united, no matter what your
politics, race or ethnic background.
Within minutes, my name was called. My first thought was that
the machine did not look anything at all like I was expecting. It
was about the size of the large machine they use at an optometrist
to check your vision, the one where you put the lenses over your
eyes and tell the doctor which picture is the clearest.
The technician introduced herself as Julie, shook my hand and
gave me the same speech I'm sure she's given many times. I would
get the exam, she would make sure the images turned out, a
radiologist would read them and I would get a phone call by the
middle of the next week if there was a problem.
We went to the machine and first she put cute little flower
stickers over my nipples. Then she pulled my breast onto a small
tray and attached something to grab the skin so the breast could be
flattened and X-rayed.
I had to stand very still and not breathe while she did the
photographing, which took about 15 seconds. Next I was told to put
my arm over the machine and lean in so she could get the underarm,
too. That felt a little more like gymnastics to me, but it was over
before it became too intense.
At no time, even leading up to it, was I ever afraid it would
hurt too much (four deliveries, remember?) and it honestly did not
hurt beyond a little pinching.
Once we were done, I sat for a few minutes while she made sure
the film was good, then she told me I was free to go.
That's when the panic set in.
For some reason, once I sat down to relax that night, I became
fixated on the fact that Julie did not look at me when she said I
was free to go. The more I thought about it, the more I was SURE
her demeanor had changed. I just knew she saw something on the
films. I went from being OK to being sure that she was thinking
about me as this poor mom who was about to get the worst news of
I will be brutally honest: I drove my husband and myself crazy
for the next four days. Doing laundry, I wondered if my husband
could handle all of it on his own. Playing with the kids, I feared
how their lives would change without me.
And then there's the Internet. I found statistics. Plenty of
statistics. Most comforting, I learned that 5 to 10 percent of
mammogram results are abnormal, but the vast majority of those turn
out to be non-cancerous. I fought the "what ifs" as long as I
Five days after the mammogram, I couldn't take it any longer. I
called my gynecologist under the guise of asking how I'd get
results. Finally, I confessed to her (on my cell phone on the
train, no less) that it was my first mammogram, I was really
nervous and I hadn't slept well in days. Could she please check for
I can say, without question, that I have never in my life said
so many Hail Marys so fast as I did during the time from when she
put me on hold until she came back and said, "I have the results
and they are stone cold normal."
The obvious lesson here for me is that I did what I had to do
and it was fine.
The deeper lesson is that the mid-30s to early 40s-the post-baby
years for many of us-are a real transition for women.
The reality is that my friends and I are talking less about
fertility methods, epidurals and diapers and more about mammograms,
cholesterol tests and wrinkle treatments. It's a reminder that our
bodies are aging and the time to take care of them is now.
I won't say I've kept every frantic resolution I made to myself
during those days of waiting, promising to eat only fruits and
vegetables and exercise daily. But I have realized that if I don't
take care of myself and my health, then the "if onlys…" that I fear
so much will haunt me down the road.
New recommendations fuel discussions
MRI scans for at-risk women
The American Cancer Society in April recommended women with an
especially high risk of developing breast cancer should get
magnetic resonance imaging scans along with their yearly mammogram.
For women at average risk, the American Cancer Society still
recommends getting annual mammograms and breast exams by a
physician, beginning at age 40. Most high-risk women should begin
getting MRIs and mammograms at age 30, the new guideline says.
Risks vs. benefits of mammograms
Women between the ages of 40 and 49 should better understand the
benefits and risks of screening mammography, according to the
American College of Physicians' new guidelines announced in April.
The main benefit of screening mammography is a decrease in breast
cancer deaths, while the risks include false-positive results,
possible treatment for lesions and radiation exposure, says the
ACP, the nation's second largest physicians group.
Jacqui Podzius Cook is a magazine editor who lives in Oak
Lawn with her husband and four children.
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