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 Furthermore, the radiology teams always used the excuse that they’re dealing with an inexact science and the outdated technology with which their profession works.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?

Relay for Life

Finally, after three years and some months, my energy and my spirit rose to the occasion, not only to passively raise money but to also actively participate in the American Cancer Society’s Relay for Life. I’m on a local San Jose team, which I came to know a couple of years ago at an estate sale. The woman who held this particular estate sale turned out to be the team’s captain. Team JBK – captained by Mary Keenan. We raised over $34,000 this year and came in first of all the teams in our area.

I arrived at 8 am, on time (a miracle) with the decorations for our two tents – about 60 bright multicolored paper flowers and long plastic Mexican banners for the Cinco de Mayo themed relay. My table full of vintage jewelry and other antique goods sold in our booth along with other team members’ donations of hand made jewelry, Home baked cookies and brownies, and a few other cool things. My wares and cash raised from my wonderful friends, my partner Craig, and my sister Jan, all totaled about $1100 bucks. My pals you can see flanking me (I’m in the middle) of the first photo – Lisa and Sue – walked with me around the track until about noon. I returned in the evening about 7 pm until 9 and walked with Craig and Lisa’s 13 year old son. Craig dedicated two luminaria – one in honor of me and one in memory of his mother. I dedicated two: one to my grandmother Leah Kaminsky who died in 1969 of metastatic breast cancer; and the other to my father, whom I lost at a young 71 in 2013 to brain cancer.

I wept and made whimpering noises as I tried to contain my emotional outpouring as we walked the track lit by the bright purple HOPE shining against the lake at Almaden Lake Park and all the other survivor honoraria and the memorials to all of our lost loved ones. The bagpipe music played Amazing Grace, and my tears flowed. For everyone here and gone, for wearing a purple “survivor” T-shirt, and for my own fears and my own life changed indelibly by cancer and its ravages. I wished my dad were here. He’d be by my side. He is by my side. So is Leah. She walks within me, beside me. I cannot remember her except in photos. But I know on that day, yesterday she burned in my mind as bright as that sign of hope.

I hope to raise more next year. Thank you and I love all of you for support and raising me up with your hope when I cannot do it myself.