On September 24, 2014, my wife Jenny had her annual mammogram. Two days later she received a letter with the results. It began,
“We are pleased to inform you that the results of your recent MAM MAMMOGRAPHY BIL DIG SCREEN-PM showed no evidence of breast cancer. We have sent this report to your physician.”
The bilateral digital screen mammogram came back negative. Always good news!
But the letter went onto say,
“Your mammogram indicates that you may have dense breast tissue. Dense breast tissue is relatively common and is found in more than forty percent (40%) of women. The presence of dense tissue may make it more difficult to detect abnormalities in the breast and may be associated with an increased risk of breast cancer.”
The qualification about “more difficult to detect abnormalities” (e.g. cancerous tumors) didn’t register until a couple months later when Jenny started noticing changes in her breast and began experiencing some pain and soreness. At that point, she saw her primary care physician who did a physical examination. That was followed by an appointment with a highly regarded radiologist who used the latest technology and performed a three-dimensional mammogram (a.k.a. digital breast tomosynthesis). He also did an ultrasound. The radiologist and his assistant shared the results on December 31. The assistant cried. It was serious and surprising. Jenny always assumed a negative mammogram meant she didn’t have breast cancer. Wrong.
Every woman should find out if they have dense breast tissue because it increases the likelihood of cancer in the breast and it is harder to detect. I’ve linked a short article entitled, “Few Aware that Dense Breasts Increase Cancer Risks” from Cure Magazine (Winter 2014). It is a year old. Here’s an excerpt.
“Forty percent of women have dense breast tissue, which is composed more of connective tissue than of fat. Research is being done to determine whether imaging with ultrasound, MRI or tomosynthesis – which generates three-dimensional images – might increase the effectiveness of breast cancer screening for those women.
“As a mean of ensuring that women are informed so that they can initiate discussion with their health care providers, 19 American states have passed legislation requiring that women be notified if a mammogram shows they have dense breast tissue, and 12 states have such legislation pending.”
I’d also encourage women to read online at places like Are You Dense?
Here is a statement from the Johns Hopkins Breast Center. Note the reference to “women who have dense breasts.”
“Mammography remains the gold standard for screening for early stage breast cancer. Many breast centers still use analog mammograms, meaning the images are printed on film. However, digital mammography is now available, allowing for the radiologist to capture and manipulate the images so abnormalities can be seen more easily.
“For example, in women with dense fibrocystic breast tissue, their breasts appear white on a mammogram. Complicating this is that tumors are also white. But with digital mammograms, the radiologist can manipulate the contrast of the images, making them darker or lighter, allowing for the masses to be identified. The images can also be enlarged on the computer to focus on areas of concern. A 3D mammogram, or tomosynthesis, can also be a valuable tool for screening and diagnosis of breast cancer in women who have dense breasts.
“At the Johns Hopkins Breast Center, when a patient comes for a diagnostic mammography to further evaluate a breast abnormality, she receives the highest quality digital imaging services available. Breast ultrasound and breast MRI are also available.”
Women with dense breast tissue should request a three dimensional mammogram and consult with their doctor about breast ultrasound and breast MRI.
John Hopkins is a world class facility but part of this statement can be misleading for women with dense breast tissue who don’t understand the considerable difference between analog (film), digital, and 3D mammograms. That is, “Mammography remains the gold standard for screening for early stage breast cancer.” Not exactly.
Jenny had three tumors in her breast. One was very large. It was late stage, not early stage cancer. Neither analog nor digital mammography detected it. Only a 3D mammogram in conjunction with ultrasound revealed its presence. That was difficult news to process. We assumed “the gold standard” of digital mammography would reveal early stage cancer.
It has been ten months since my dear wife was diagnosed with stage 3 breast cancer. Her treatment has entailed 92 medical appointments and procedures (one every three days on the average) including 4½ months of chemotherapy, 2 surgeries, and 6 weeks of radiation therapy. Last Wednesday, she finished radiation.
The photo below is from the radiation oncology center. The sign says, “Ring this bell, three times well, its toll to clearly say; my treatment’s done, this course is run, and I am on my way.” (Irve Le Moyne)
My wife’s smile is amazing! No one would know she was in extreme pain from the cumulative effects of comprehensive radiation to the region that resulted in grade 3 radiation dermatitis. The oncological radiologist apologized. His goal was grade 2. At first he prescribed tramadol then hydrocodone then oxycodone. The narcotics had little effect upon the pain and she preferred doing life without them. Thankfully she is starting to heal and the pain is lessening. This is but one snapshot from the past year. There have been many other complications throughout the process – some lasting.
On Sunday night, we celebrated and gave thanks to the Lord for his sustaining grace. Jonathan & Katie and Seth & Carolyn joined us at Outback Steakhouse and relatives from outside of North Carolina sent gifts and cards. It was a joyous time. Of the long and arduous journey, Jenny remarked, “It has been more about the Lord holding onto me than me holding onto the Lord.”
That is so true and yet we all admire her courage and the godly attitude she has maintained throughout this mental, emotional and physical trial. Cancer fatigue is real. So too the assorted pain and sickness. Whiling enduring great hardship she has been a testimony of true Christian faith.
When able Jenny has continued to work her job as a certified medical assistant at a large family practice with nine full time doctors and more residents. They love her there! The lead doctor and director of the practice recently sent me this note.
What a journey this has been! Your wife, is beyond a doubt, one of the most incredible people we have ever worked with. So humble, strong, and resolute. I hold great hope that her treatments will be successful. If there is anything you or she need anytime, please don’t hesitate to let me know. I hope that every October from here forward we will look back at Breast Cancer Awareness month with an appreciation for what she has endured to achieve her cure and move our energy onto screening and treating others!
On Monday, Jenny started hormonal therapy. She will be taking a drug in pill form that is designed to prevent reoccurrence by killing regional or distant cancer cells if any exist. In six months, she will undergo reconstructive surgery. Between then and now, there will be more appointments and tests but at a reduced rate. For that we are very grateful.
Jenny has plans for the coming year. I have plans for the coming year. But like everyone else on the planet, those plans (and our physical existence) are dependent on the sovereign will of Almighty God whether young or old, healthy or sick, rich or poor. James presents us with a biblical worldview of living and dying in his epistle.
James 4:13-15 Now listen, you who say, “Today or tomorrow we will go to this or that city, spend a year there, carry on business and make money.”  Why, you do not even know what will happen tomorrow. What is your life? You are a mist that appears for a little while and then vanishes.  Instead, you ought to say, “If it is the Lord’s will, we will live and do this or that.”  As it is, you boast and brag. All such boasting is evil.
This passage does not teach fatalism. We are called to be industrious and improve our condition where possible. It does, however, teach humility. Our plans are always subject to his plans. I don’t know what will happen tomorrow but I know who does. I also know he alters the affairs of men through prayer.
Therefore, we’d appreciate your ongoing prayers for health and healing. God is wise, good, and sovereign. That’s why we trust him, and not ourselves, for all things including the gift of eternal life through death and resurrection Jesus Christ.
There are medical reasons to be hopeful in Jenny’s case but we must all keep in mind the eternal perspective of Paul the apostle. “For to me to live is Christ and to die is gain.” (Philippians 1:21) How about for you? Do you see death as gain because you go to be with Christ? I hope so. If not, learn how to live for him now because when life is about Christ, death is about gain. What great options for the follower of Jesus Christ!