CullmanTimes.com - Cullman, Alabama

May 15, 2013

Her Doctor Dismissed the Lump in Her Breast

By Kathryn Petrides
The Washington Post

With this article, Kathryn Petrides begins writing an occasional series for The Post that will focus on what she calls "balancing life as a 'normal' 26-year-old and a cancer patient." 

It was on the weekend of my 25th birthday that my boyfriend alerted me to a lump in my left breast. At first dismissive of his concern, I eventually promised to see my gynecologist. I was due for my annual exam anyway.

About three weeks later, I walked away from the doctor visit confident and reassured. My gynecologist conducted a breast exam, made note of the lump's size and sent me on my way. She didn't order a mammogram or an ultrasound or suggest a follow-up appointment.

"She said considering my age and family history, it's probably just a cyst or a fibro-something and to keep an eye on it," I reported back to my boyfriend.

So, I continued with my normal life in Washington, where I've lived since 2005.

Fast-forward to July 2012, more than six months after the discovery of the lump. I had been accepted into a program to teach English in Leon, Spain. I gave notice to my employer here, completed the paperwork for my visa and booked my plane ticket. Dreaming about tapas and siestas, I'd forgotten about the mass in my breast. My boyfriend hadn't, and he urged me to follow up on it.

Deep down, something told me he was right. You can probably guess what happened next.

I have cancer, an aggressive kind that has already spread to my lymph nodes. In official "cancer talk," I have grade three invasive ductal carcinoma that is estrogen-, progesterone- and HER2Neu-positive. I chose to participate in a clinical trial that entailed neoadjuvant chemotherapy — a fancy way of saying chemotherapy before surgery — so I will never have an official staging because they cannot know with certainty how many of my lymph nodes contained cancer cells.

Since my diagnosis, I have received 16 chemotherapy treatments and undergone a nipple-sparing double mastectomy. Currently, I am wrapping up 28 radiation treatments. In addition, I continue to receive Herceptin via IV every three weeks, as well as hormone therapy that consists of ovarian suppression drugs and tamoxifen.

Given the aggressiveness of my disease and its treatment, people often become upset when they learn how long it took my cancer to be diagnosed. Many express anger at the practice where I had my breast exams. A few people have even suggested that I look into legal action.

I choose not to walk down that path, though. Sure, sometimes I allow the thought to creep into my head. What if it had been caught earlier? Would it still be in my lymph nodes? Would my prognosis be better? As soon as they pop up, I try to kick these thoughts to the curb. I will never know the answers, and blaming someone won't change my current reality. I choose to focus my energy on a path toward healing, not fault.

Besides, part of me understands. Given my lack of a strong family history of breast cancer and my age, I am an outlier, to say the least, from the normal breast cancer patient.

In a lifetime, the overall risk of a woman's developing breast cancer is one in eight. But try looking up statistics for having breast cancer at age 24, when my lump was already there, and you won't find any. Even the risk calculators you get at the doctor's office begin at age 30.

Adding insult to injury is the fact that breast cancer in young women is associated with lower overall survival rates than those of older women. A 20-something woman could have the exact same diagnosis as a 65-year-old patient, but her prognosis is worse based solely on her youth.

Over the next few months, I will be writing about my experience. I'll write about my uncomfortable foray into medical marijuana use and the emotional challenges of cancer support groups. I'll also write, more simply, about balancing life as a "normal" 26-year-old and a cancer patient.

On the one hand, I still go to work, make brunch plans with my friends and dream about future trips and goals. On the other, I struggle to come to terms with an aggressive cancer diagnosis and my own mortality.

Will I be around for those trips my friends and I talk about taking together as old women? Do I continue to invest in my retirement plan — or cash it out now and enjoy the trip of a lifetime while today is here? Will I be able to have children after treatment, and, if so, do I still want to? Not long ago, I took for granted that I would grow old. Moisturizers and eye creams were invested in. Now, I catch myself staring at older women and wondering if I'll be so lucky as to have crow's feet.

But my story is not meant to be a weepy or dramatic one. And it is not just my story. Twenty- and 30-something women may be at lower risk of getting breast cancer than other women are, but it still happens.

With all the recent hoopla about mammograms and their efficacy, the best advice I can offer women younger than 40, the recommended age for a baseline screening, is to know your own body. Neither an ultrasound — used to detect cancer in young women because our breasts are denser, thus making mammograms unreliable for screening — nor a mammogram "saved" my life. What allowed my cancer to be caught was following up on something I knew wasn't right, even though it was initially dismissed by a medical professional.

So, yes, this diagnosis has changed my life. But while I struggle with fears of recurrence or metastasis, I still have hope for those crow's feet. Forget money or fame. Wrinkles are one of my goals now!

Petrides works in an administrative position at the Peace Corps.