More Than Wearing Pink

I’m not celebrating breast cancer, obviously, but I am grateful for Breast Cancer Awareness Month, and the advocacy work it promotes to encourage women to schedule their mammograms and be aware of changes in their breasts that could save their lives.

I had my first mammogram at 25. My doctors knew my family history and encouraged me to schedule annual exams long before I knew I carried a BRCA1 gene mutation. Later, I added MRIs and ultrasounds to my regimen.

I have often shared that I lost my mom to breast cancer when I was 14, but I don’t often go into the details of her diagnosis, or that her sister lost her battle with ovarian cancer only five years earlier.

My cousin is an ovarian cancer survivor and was tested for the BRCA1 mutation more than 20 years ago. When she learned she had the mutation, she encouraged me to get tested. I did, and after a few tears, I realized how powerful that information was. I could take control of my health decisions in a way my mom and her sister never could.

I recently read a diary entry from my mom. After her diagnosis, she had a single mastectomy. In 1981, they had no idea how dangerous the disease was for someone like my mom. She went through one round of radiation, and because it made her ill, she opted for an alternative treatment in Mexico. It was some type of holistic medicine with a strict diet that included raw eggs.

Looking back, it seems obvious that there was a lot of snake oil being sold, but my mom believed fully in the treatment. Her last diary entry confirmed that belief. She even felt sorry that her sister hadn’t known about it. She was 100% certain it would cure her completely.

Two months later, she was gone.

Twenty-five years later, I proactively took control of my own health and significantly reduced my chances of developing cancer.

When the Revlon/UCLA Breast Center heard my story, the doctors recommended a full hysterectomy, including removal of my ovaries and fallopian tubes, because of my BRCA1 mutation and the ovarian cancer diagnoses of my aunt and cousin. Ovarian cancer is often difficult to detect until it has reached a later stage. My cousin was lucky.

She has been cancer-free for more than 20 years.

We also discussed a preventive mastectomy, but because breast cancer screening could potentially detect cancer early, I initially opted against the surgery.

Three years later, a friend encouraged me to rethink that decision. My lifetime risk of breast cancer had been estimated at as high as 80%. After a preventive double mastectomy, I was told my risk had dropped to about 2%.

I still have annual exams, but I no longer need mammograms, MRIs or ultrasounds. Because doctors can’t remove every breast cell, my risk isn’t zero. But I am thankful that it is now very small.

There was another consideration. Breast cancers associated with BRCA1 are more likely to be triple-negative, an aggressive form of breast cancer that lacks some of the targets used to treat other breast cancers. Knowing that made prevention even more important to me.

By the time my mom and aunt died, their cancers had metastasized to other parts of their bodies. For my mom, it had spread to her bone marrow, and ultimately, her cause of death was a brain hemorrhage.

As I reflect on Breast Cancer Awareness Month and wear a little more pink than usual, I am grateful that I can encourage others to get screened and be proactive about knowing their risks. Some risks, like genetics and family history, we can’t change. Others we can influence.

Here are a few facts many of us may not know:

• Alcohol: Breast-cancer risk increases with alcohol consumption. Research has found about a 7% increase in relative risk for each alcoholic drink consumed per day. Even light drinking is associated with some increase in risk.

• Weight: Excess body weight is associated with increased breast-cancer risk, particularly after menopause.

• Smoking: Smoking causes many types of cancer. While the relationship with breast cancer is less clear than it is for alcohol, there are plenty of reasons to avoid tobacco. Don’t smoke.

• Physical activity: Studies have found that the most physically active women have about a 12–21% lower risk of breast cancer than the least active women.

I might think about breast cancer more often than most. But if my words encourage just one woman to get screened, learn about her family history, make a healthier choice or find her cancer early, I know it’s worth it.

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