Today I experienced that age-old, womanly rite of passage: my very first mammogram!
At 33, I’m a little young, traditionally speaking. With my family history, it’s actually a bit later than I would have liked, but I was nursing babies for most of the last six years, which I understand makes mammograms a little useless. But the gals have dried up, and I had my annual womanly last week, and here we are.
The insurance company seems to feel I’m too young as well and so declined to pay for the mammo, even though my gyno sent over a referral. Family history be damned! I paid out of pocket for this one, because I, unlike the insurance company, do not wish to wait until I am 40 to get at least a baseline screening.
My foreboding family history is thus: my maternal grandmother survived breast cancer twice, and my mom died from it.
The first time my grandma had it, if I’m not mistaken, she was in her 40s. The doctors removed the affected breast; some time passed; cancer presented in the other breast; they removed that one as well. One or both of the mastectomies were “radical,” meaning they took not only the breast tissue, but also a lot of underlying muscle tissue. She also went through intense radiation therapy. All of this left her rather crippled. I remember her shuffling around, often with a cane, and having a lot of pain and weakness. My dad would say she was “stove up.” She lived to be almost 80 and died of unrelated causes.
My mom was diagnosed with cancer in one breast at age 52. By this time, medicine had advanced to the degree that the doctors did not “have” to take her breast. They removed the lump, and they removed the affected lymph nodes. Though the cancer was “stage 3” and had spread to some nodes, it did not appear to have spread anywhere else. She did chemo and radiation, lost her hair, and felt determined to beat the cancer. Then she started getting terrible headaches and acting weird, slurring her speech, forgetting words, and saying bizarre nonsense things. Another scan showed the cancer had metastasized to her brain and spinal cord. The doctor said her spine was so covered with tiny tumors that it looked like someone had rolled it in sugar.
My mom died at 53. Total time from diagnosis to death: about nine months.
Long before Angelina Jolie did it, I have said that I would consider a prophylactic mastectomy. My mom had genetic testing after she was diagnosed, and it was negative, but that was in 2005, and I don’t remember exactly what testing she had. It was probably a BRCA, but was it 1 or 2, or both? Some cursory Googling tells me some new tests have emerged since 2005, so certainly she didn’t have those. If I were positive, I would definitely consider mastectomy. The question might be less if, more when.
And I have also long said that I want my boobs hacked off, both of them, at the slightest sign that anything resembling cancer might be lurking in either one of them. I mean anything. I don’t want to “keep an eye on it.” I don’t want to “save the ta-tas” (not in the literal sense, that is). In my job, I’ve read far too many medical records showing doctors’ “wait and see” attitude, when they waited and got to see expanding malignancies. And my mom seemed so pleased that the doctors did not “have” to take her breast. Pardon my language, but fuck that shit.
But should it ever come to that, it seems insurance may pose a stronger barrier to my admittedly extreme, better-safe-than-sorry goals than it did today. I paid $163 for a mammogram and a consultation. In 15 years, if something shows up on a mammo my insurance company does grudgingly pay for and I ask for the nuclear option, insurance may politely decline to pay for the red button. And the red button isn’t cheap.
In the meantime, today’s experience wasn’t all bad. The mammogram was like having my boobs smashed like two patties in a giant Plexiglas burger press, which was an uncomfortable sensation, to be sure, but also more hysterical than anything else. And the clinic I visited has styled itself with the accouterments of a spa. I covered myself not with a crinkly paper gown but with a cotton, waffle-weave robe. The lighting was subdued; soothing music and nature sounds played over the speakers. I was treated to a complimentary chair massage when the boob-smashing was finished, and I left with free deodorant and lip balm and a chance to win a Coach bag.
And one of these things:
When I think about my family’s history of cancer, I usually think it’s only a matter of time until I get it. More when; less if. And realistically, even vigilance with mammograms and self-exams and all the rest aren’t fool-proof. My mom was vigilant; she found her lump. She sought treatment as soon as she could. She still died. The best I can do is try to learn from her experience and be my own advocate. Maybe fighting with insurance companies now, when I’m 33, is good practice for later, when it will count.