Dense: Very Stupid Breasts Outsmart Early Detection

Have you also noticed a sharp increase in the number of tweets and other social media posts regarding the importance of early detection in early stage cancers? I noticed a huge rise in mentions of mammography and self exam as tools in the messaging as well. Perhaps it’s my overactive brain looking for data points. Somewhat like playing “punch bug” as a kid: looking for different colors of VW Beetles in snail pace creeping traffic to satisfy my need to punch my little brother in the arm. In this matter, pretend I’m my brothers arm and the fist punching me is early detection. If it is the best prevention of breast cancer then I have a very bruised arm.
“Oh look! Punch bug pink!”
Slam! (out of nowhere a knuckle fisted puch lands sqarely on my brother’s shoulder.)
“Ouch! That hurt!” He starts crying alligator tears.
“Shut up! You’re so dense. We are playing punch bug!”
“Mom she’s hitting me again!”

Presenting De Novo
In cancer language de novo, roughly translated from Latin, ironically a dead language, means from the start. With dense breasts, cancer can go years undetected by standard (and very painful if you’ve got dense tissue) mammograms and the occasional ultrasound. And my stage four metastatic breast cancer wasn’t showing up for years on radiologists’ radars because of dense tissue. I always got an inconclusive decision with regards to the results. But the fact is, not one oncologist looked at the ultrasounds. Furthermore, the radiology teams always used the excuse that they’re dealing with an inexact science and the outdated technology with which their profession works. Amortization of medical equipment takes many hundreds if not thousands of tests and at least 10 years. Technological rates of change by Moore’s Law standards means we are at a minimum five years behind and this is a generous estimate.

So when I “presented” at the hospital in 2015, the diagnosis left me nonplussed. At 4:30 am a doomsday call went out from a nurse in the ER to my overtired, shower-deprived husband. He was asked to return to the hospital immediately and to come to the oncology floor. When he arrived we both sat wide eyed and exhausted from the day’s events waiting for the punch in the arm.

Slam! Ouch.

I received the tectonic plate shifting news with a prognosis of months to live based on that night’s CT scan. The results showed cancer cells taking up residence in each and every organ within my fluid-bloated belly. I reacted with the steadiness of a third grade teacher at 2:59 on the last day of the school year. My response: nope, not going to happen. I’d wait for further tests to come back as my intuition rang like the three o’clock school bell in that same classroom yet from a 10 year olds perspective, telling me I could run from the room and down the hallway to a reprieve from doom. From the hard punches that awaited me in a world of colorfully painted punch bugs.

Slam! Ouch! Stop it!

I hate the pink ones most of all.

I was partially correct, in that cancerous abdominal ascites fluid can appear to leave traces of the cancer cells like a swimmer floating around a pool on a sunny day. The cells cast cancer shadows everywhere and leaving radiologists not trained in oncology mystified I suppose. There goes the technology failing me again. The correct diagnosis, the wrong prognosis.

I’m now at the cusp of the end of my fourth year since the 25th day of March, 2015. So how did early detection help in my case? The technology failed me, my General Practionier failed me, and my killer boobs failed to warn me that I’d get punched over and over. They’re dense though. Exceedingly stupid. An IQ of two – one point each and a very generous point in my opinion.

So if you like me have stupid dense breast, and you cannot even feel a single lump because it’s all lumps, ask for a 3-D mammogram and if that’s not available yet for you, get an ultrasound. Have it read by someone qualified to read it. Please don’t wind up de novo if you can let early detection try to work for you.

Slam! No one told me.

Ironically, the color of the ribbon for metastatic disease is pink, green, blue and white – the same colors of my bruises as they just blossom before they heal. I’m weird, yes, but then perhaps my metaphor isn’t so silly at all.

“Mom! It’s hitting me again! Make it stop.”

Dense boobs, will they ever learn?