**Copyright 2022 Maria Teresa Brown - All Rights Reserved**
Part 1: The First Go-Round (or Ductal Carcinoma In Situ)
Chapter 1: Mom
I will start my story by telling you that I am not the only woman in my family who has had breast cancer. While neither of my grandmothers had it, as far as I know, or any of my aunts, my mother did. It was found during a routine mammogram, and she had a complete mastectomy on that side, but no other treatment. After the mastectomy, she wore a prosthetic or not, depending on her preference on any given day. Her cancer was found when she was 63, and she remained cancer-free until her death at 81.
At the time of her diagnosis and mastectomy, I was in my late 20s. I had been sober for a few years, but was still a heavy smoker. Around that time, I knew of a women in my local community who had breast cancer and was a heavy smoker – she had a mastectomy, kept smoking, got metastatic[1] breast cancer, kept smoking, and then she died. All within a few years. It seemed really fast and frightening to me. All I could think about when I heard my Mom’s diagnosis was that now that breast cancer was officially “in my family” I didn’t want to be dealing with having breast cancer and trying to quit smoking or being unable to quit smoking and dying from cancer because of it. That was the year that I began making my first serious attempts at quitting smoking. It took several years and multiple failed attempts, but I did finally quit smoking for good the year that I turned 32.
Now, I don’t know for sure if cigarette smoking has ever been proven to cause breast cancer, but if your mother, a heavy smoker, had any kind of cancer, you would probably find yourself wondering if her smoking had anything to do with it. In my mother’s case, she did not quit smoking. Ultimately, she developed COPD, and her official cause of death was “complications of COPD.” Mom’s smoking was not something I could change. But I could change my own habits, and so I focused on that. And one of the first things I thought the first time I was diagnosed with breast cancer was “thank God I quit smoking when I did!”
Since my first diagnosis, alcohol abuse has also been linked with breast cancer. As I mentioned before, I was already sober a few years when Mom had her mastectomy, and I was sober 12 years when I had my first breast cancer. My doctors have always been confident that my history of alcoholic drinking was distant enough not to be linked to my breast cancer. I am not as confident, but I am certainly grateful that I was not still drinking when I was diagnosed. Because the only thing that was harder than quitting smoking for me was quitting drinking. And I would definitely have been told to do both once I had breast cancer. Whether I would have been able to, though, is highly unlikely.
This chapter is about Mom, not just because of her history as a smoker and a breast cancer survivor, but because of my role as her caregiver throughout the years that I was dealing with facing and surviving breast cancer.
I was diagnosed with my first breast cancer in August of 2002. I had already spent pretty much every day of that summer at the hospital, trying to figure out what was happening to my mother. That spring, she had been moved out of the apartment she shared with Dad into a homeless shelter for mentally ill women, and eventually into her own apartment in an enriched housing program. Her enriched housing program was essentially independent living for older or disabled adults who qualifid for Social Security Disability, Medicaid, and public housing. It was not a good transition. She was very unhappy, and her health was bad. While she had lived with bipolar disorder all of her life, she was additionally depressed about being separated from Dad, but he just didn’t want to, or couldn’t, take care of her anymore. She also started getting really forgetful. More than I even realized at the time. Nobody was aware of it, but she was experiencing a medical condition – hyperparathyroidism – that was causing all the calcium in her bones to leak out into her blood. This caused hypercalcemia, which caused the memory loss and started making her fall. The worst fall broke 2 vertebrae in her back and split her head open, landing her in the ER. They discharged her back to her apartment that day, which felt unsafe to me, but I didn’t know what else to do. A week later, she was completely incapacitated and had lost most of her ability to speak. She was back to the ER, and this time admitted into the hospital. Within a week, and before they could figure out what was going wrong, she ended up spending 20 hours in a coma. She survived the coma but was what they called “severely demented” for weeks afterwards. When she was well enough, they discharged her to a nursing home. And she lived in nursing homes for the rest of her life. Her dementia became less severe after that initial hospital stay, but she never recovered her short-term memory or her capacity to take care of herself well enough to live outside of a nursing home.
In the middle of Mom going through all of that, I went to the gynecologist for an annual exam. I had been living in Syracuse with my partner for a year and a half and had not been to the gynecologist since before I moved. Which meant I was overdue for an annual exam. I hated going to the gynecologist, mostly because it is an unpleasant experience for any of us, but also because of repeated questions about birth control (no matter how many times I told them I didn’t have sex with men, they just kept asking those questions!) and my history as a sexual abuse survivor. So I had been putting off my first visit to MG’s gynecologist. Eventually, her mother told her to just make the appointment for me if I wouldn’t do it myself. The best advice ever, it turns out. MG made me the appointment for that July, and so like a good girlfriend, I went. The gynecologist’s office was in the same building as an imaging office, so she sent me right over for my baseline mammogram.
I was only 36, and since Mom’s breast cancer a few years earlier, the former gynecologist had told me I didn’t need a mammogram until I turned 40, because Mom’s cancer was post-menopausal. But MG’s Mom, and their gynecologist, believed in early baseline mammograms, so that you have images to compare to when you start your regular mammograms at age 40. This is why I was sent over to imaging for a mammogram. The physical examination of my breasts was totally normal.
The events of that afternoon are not entirely clear anymore, it was so long ago. I know they wanted a magnification of my left breast, because the radiologist wanted to take a closer look at it. Which means that I had to have extra mammograms done on that side. And I know that the area they were concerned about was very close to my armpit, so they really had to pinch my breast in the machine, which hurt. After the second image, the technician sent me back to my gynecologist, who told me that there was a suspicious area in my left breast and they needed to refer me to a breast surgeon. Before I left their office, I had an appointment with Dr. G, who ended up being my breast surgeon for both breast cancers.
[1] Metastatic breast cancer is when the cancer has spread to other parts of your body (like your liver, brain, or bones) or comes back (recurs) after you have complete treatment for the initial cancer. Some people might call it systemic cancer, or stage four cancer, or end stage cancer. At this point, the cancer is not curable, although depending on the particular details of an individual case, it may be manageable with the appropriate treatments, and some women have been known to live for many years with metastatic breast cancer.
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