Stage 4 or bust? No thanks

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Teresa Talerico

Teresa Talerico

Women’s History Month offers digital mammograms Thursday in the mall. To ensure early detection of breast cancer, younger women should combine mammograms with other screenings, perform self-exams and trust their “titstincts.”

By Teresa Talerico

A woman knows her own body better than anyone.

That’s why trusting her instincts about it is as important as getting annual breast-cancer screenings after age 40 — or earlier, depending on family history and other factors.

I speak from experience. On April 22, 2013, I was diagnosed with breast cancer, which had gone undetected on a mammogram 11 months earlier and still sneaked under that same radar by the time I had a palpable lump.

I might have caught the cancer even sooner if I had trusted my instincts about my body.

The doctors might have caught it even sooner if they had combined that first mammogram with a right-breast ultrasound.

I might even be cancer-free today. Instead, nine months after my original diagnosis, I learned it had metastasized. Now, cancer will remain a permanent squatter for the rest of my life.

As part of Women’s History Month, this college will offer digital mammograms 8:30 a.m.-4 p.m. Thursday in the mall. Women must register in advance at or call 210-486-0127 for more information.

The mammograms, conducted by University Health System, are open to the public and free for women over 40 with no health insurance. This is a much-needed service as those women are less likely to get breast screenings. In 2010, less than a third had received mammograms within the past two years, compared with 72 percent of insured women, according to Cancer Prevention and Early Detection Facts & Figures 2013, an American Cancer Society report.

And certainly, today’s digital mammograms — particularly the 3-D variety — do a better job than old-fashioned film mammograms.

Still, they are not always enough, and we should not let our guard down between screenings.

Like many women, I found my cancer myself, in the form of a lump, less than a year after a May 2012 digital mammogram had given me a clean bill of health.

I say “less than a year” because I honestly can’t recall when I first noticed the small growth. I know it wasn’t during one of those self-exams, which I admit I rarely performed. I probably discovered it by accident, while taking a shower or getting dressed. This is the way many women discover their own cancer, according to the National Breast Cancer Coalition.

I was definitely aware of the lump by January 2013. That month, I wrote a newspaper story about a Norfolk, Va., cancer charity. I remember feeling like a hypocrite for covering this story and not addressing my own little space invader.

But had I suspected something as early as November 2012? I still rack my brain about this. And it shocks me to think I may have waited as long as four months before seeking medical attention.

Regardless of when I found the lump, I immediately went into denial instead of immediately calling the doctor.

After all, at 44, I was relatively young for the disease — or so I thought.

I would later meet many 20-something survivors in support groups.

After all, no one in my family had ever had breast cancer. I would later learn the genetic mutations that cause breast cancer often have little to do with heredity, despite the attention surrounding BRCA, or, as I call it, the Angelina Jolie gene.

After all, I had always been a bit of a hypochondriac prone to overreacting. In 2011, a chest rash convinced me I had inflammatory breast cancer, which is less common than my later diagnosis of invasive ductal. The doctor suggested I switch to a different body wash.

And after all, I had been getting annual mammograms like clockwork since I turned 40. My doctors even did occasional ultrasounds because of my dense breast tissue, a common condition in younger women that can make it difficult for mammograms to spot abnormalities. For some reason, they only did an ultrasound of the left breast — and not the traitorous right side — in 2012.

I also had a history of noncancerous fibrocystic changes, particularly on the right. I remember how the radiologist showed me those benign cysts after a 2011 ultrasound, how he gently pressed my fingers over those areas of skin. Nothing to worry about, he said. Just remember they’re at the “9:30 a.m.” and “noon” spots.

So, for all of those reasons, I doubted myself. I denied. I rationalized. I convinced myself the little lump was just one of those pesky fibros.

To be fair, I wasn’t always thinking clearly in late 2012. My husband and I were grieving most of that year. My dad died in February, and my mother-in-law died in September — of breast cancer. In October, my elderly mother had a heart attack and a severe case of shingles.

We lived in Virginia then, so I spent almost a month in San Antonio taking care of Mom.

By November, I desperately wanted to spend the holidays with my husband and regain some sense of normalcy.

For a few precious months, we achieved it.

In January 2013, we traveled to Richmond to see a Los Texmaniacs concert, visit the Edgar Allan Poe Museum and see the Dale Chihuly sculptures at the Virginia Museum of Fine Arts.

For Valentine’s Day, we saw “Silver Linings Playbook” at a Norfolk movie theater.

And then I noticed the lump was getting bigger.

Or was it?

I doubted myself a little more and then realized how selfish I was. My husband’s mother had just died of breast cancer, and now I was being so reckless with the health of his wife.

By March, I was at the doctor’s for a mammogram, ultrasound and biopsy.

By April, a surgeon was giving us the bad news.

By June, the bilateral mastectomy and reconstruction were proclaimed a success, the lymph nodes were declared negative and my chances of recurrence were predicted at 4 percent. I wouldn’t need chemotherapy, just five years of a pill called Tamoxifen to keep estrogen at bay. My breast surgeon literally chirped “yee-haw!” when she called with the good news.

But by January 2014, the cancer had returned as a lesion in my L1 vertebrae.

It’s now officially incurable. Henceforth, it’s a waiting game to see where it pops up next.

I’m OK today. Great, actually. I feel strong, happy and blessed. With radiation, new hormonal drugs and other treatments, my prognosis isn’t as good as it was for Stage 2A, but Stage 4 does have a silver lining: In cases of oligometastatic breast cancer in the bones — meaning it has spread to just a few spots — women can live for many years, an oncologist said at a 2014 breast cancer conference I attended in Philadelphia.

During the Q&A period, I asked how she defined “many years.”

Up to two decades, she said. The whole ballroom applauded.

Cancer gave me the courage to speak up in that room. It also gave me the courage to start teaching where I learned journalism.

Still, I would rather have learned to be brave without it.

So my advice?

Get in touch with your own boobs. Develop your tit instincts. Call them “titstincts” if you prefer hip euphemisms. You don’t even have to obsess about it. You’ll know when something looks wrong or feels strange.

To paraphrase Ice Cube, check yourself before you wreck yourself. Ask your doctor if you have dense breasts. If you do, demand 3-D mammograms, ultrasounds or MRIs. And when the doctor says it’s nothing — because most breast changes aren’t actually cancer — you can celebrate with a sexy new bra.

But always trust your gut when it comes to your girls.

Teresa Talerico is a journalism full-time adjunct and an adviser to The Ranger.


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