The videos in this section walk you through several aspects of breast cancer diagnosis, care and treatment.
Follow along in this video as one woman shares her journey through the diagnosis and treatment of breast cancer.
So what do you have for this one? What are you going to come up with? So I'm doing in the simplest form still. OK. So it's 36 over 42. Easy. 6 times 6. At 37, I was in a really good place. I felt the best I'd ever felt. As a single mom with elderly parents, I always found myself in the role of caregiver. As women, I think we take on that role for everyone around us, often to the point of not taking enough time for ourselves. What made me slow down to take that moment for myself with that my niece had died of cancer, and I knew that I needed to be mindful of doing my own self-exams, and so forth, and keeping on top of my health. So I thought of it one day in the shower. I did my own check, found a lump, didn't think a whole lot of it, called my OB-GYN, scheduled an appointment to come in. She found a second lump. She said, I think you need to have everything checked out. I did that. During the ultrasound, they found a third lump. I had a mammogram, and in my case, actually, the mammogram showed nothing. When the mammogram's really dense, it can be very hard to find a cancer because we're looking for a white thing-- which cancer would be, it's very dense-- in a background that is mostly white. So it's a lot harder than if we were looking through somebody with a fatty breast where their tissue is like a light gray to kind of black, and then we're looking for something white and it really stands out much more. And with a very white background, it's very hard to find a little mass, or a little even calcifications sometime. I think in a way I had an inkling because I persisted with getting a biopsy. And I've talked to so many women who've told me that if they didn't present clinically with breast cancer, that they would not have gone through a biopsy. They'd heard that it was painful. They'd heard, you know, whatever. And they would have left it at that. So I think somehow I knew that I needed to get this checked out. And plus with my niece who had passed away previously, that was always kind of in my mind. I needed to do everything I could do. But yeah, I also kind of thought, you know, this is going to be fine. I'm young. I'm healthy. It won't be anything. And I remember getting the call that night. I remember sitting down in my bedroom in the dark. And I needed it to be dark. I needed to have all senses focused on just that information. And it was overwhelming. I didn't believe it. So I'm trying to find information, trying to find the right path for myself to take, and really coming up short, feeling like I have no idea where to go, no idea who to talk to, no idea what to schedule next. And the whole time, certainly, I felt this way. I don't know that everyone does. But I've talked to other breast cancer survivors. You feel like it's a ticking time bomb. And you feel like you need to do something immediately to get this cancer out of your body. You feel like it's multiplying exponentially. It's not, but there's a definite sense of urgency. And I was looking for somebody to put a team together and let me know what we needed to do next. After one of our patients gets her diagnosis of breast cancer, we're the first person usually that she talks to right after that phone call. And we're the person then that will just help her make her appointments and kind of guide her through that initial shock and stressful time. I'm just kind of letting her know that we're going to be there to get her through that initial part, and help her make appointments, and kind of get things scheduled for her, and give her support at that time. Yeah, we're all part of a big team. And I think one of our main roles is right in the clinic, is working with all the different specialty doctors that come into our clinic-- from the surgeons to the oncologists to the lymphedema to the genetic piece of it. And a big part of what we do is patient education. And the more we can educate patients, the more it helps them relieve their stress and anxiety of not knowing what this whole process is all about. Yeah, I think for the patients, the big fear for them not only is the breast cancer diagnosis, but it's the fear of the unknown. And if we can make what is unknown known for them, they can make good choices. We want the patients to feel that they're being cared about when they're here, but it doesn't just end when they walk out of our clinic door. That we care about them and want to help them through this whole process, even when they're home. And I always tell my patients, call even if you have a half a question. You don't have to wait until you have a whole page of questions. And there is no stupid question. Patients always say, oh, this might sound a little stupid. And you're like, absolutely not. I think it's stressful for patients to make that decision of when can I call? I don't want to be a bother. And we want to take that away, and when we encourage them to call. Unfortunately, or fortunately, we're contained in the clinic. You know, we have patients that come every day. We have to have-- we have to stay here. We can't go to other appointments with them because we have patients coming in that need us here. And I think that's kind of the extra piece of the are coordinators is that they can be more of a liaison for other appointments, that type of thing. So we will help that patient get that appointment, but unfortunately, we can't accompany them because we have to see the patients that come through here. So cancer care coordinators are really kind of an extra layer of support for the patient throughout the entire process. We are here to make everything easier for the patient. We connect with them, either right at the time of diagnosis or when they come in for their surgical consult. And we help to provide support-- reaching out to them at specific times; visiting them in the hospital; helping them during the transition times when they maybe transition between after surgery, and then they're now going to be meeting up with the medical oncologist; through their-- if they require chemotherapy, connecting with them during that time, not as the chemotherapy expert, but as the support person expert; then through the radiation process. And again, not as the radiation expert, but as, is there things that are occurring that we can help the process be a little bit easier for them. We are there for financial support if patients are having issues that come up with their billing, or their financial situation changes, connecting them maybe with the cancer legal line if there are things that are going on with their employment, connecting them with the social worker if there are things that are going on with maybe their housing or their family, that it's going to require even more support than a cancer care coordinator, then we help to involve the whole team. Jennifer, you want to come with me? OK. So when I first see a patient, I will gain the history, review the family history, review imaging and pathology, and then I'll examine the patient. And then I'm going to have you lie back and I'll feel your breast. OK? Once that's done, I sit down [INAUDIBLE] and hopefully some additional family members or friends. We do encourage that you have more than one set of ears listening so that you don't miss things. And then I will offer them what is appropriate, what are appropriate options for a surgical intervention. Family history may be very important when it comes to breast cancer in that I do want to screen people for genetic mutations if it's appropriate in that it may alter how they decide to proceed operatively, both as it relates to their breast tissue, but also possibly as it relates to their ovaries and fallopian tubes. As it stands today, if you do a mastectomy-- If it's appropriate, I will offer all options to a patient. Now ultimately, in the end, it's an individual choice how they want to be treated. And so in a patient who may be a good candidate for lumpectomy, she may choose mastectomy. And that's her choice. I just have to make sure she's making it for sound reasons. I have to recognize that the survival is the same. If you're going to need chemotherapy, you will get it regardless of what operative procedure you want. The big difference will be the need for radiation, potentially. And then there can potentially be differences in terms of how we treat nodal disease. I had been trying to schedule an appointment with the geneticist because to me, I wanted to find out if I had-- that was part of my decision for deciding whether I wanted to do unilateral versus bilateral mastectomy. I felt like that was how I could gather my information and move forward. I couldn't get in for the geneticist until two months after my scheduled surgery date. So it didn't jive, and I was frustrated. And she scheduled at all for me within the next week. And the burden that she lifted that day, it was immense. I had a team in place. I had a plan. I could move forward. I didn't have to worry about the details, about finding a phone number for the right person to call. I knew I could trust her. I knew she knew the right people to talk to. I knew she knew the process. And she was exactly what I needed. The appointment with the plastic surgeon was, I think, very informational. It hit home. [INAUDIBLE] I think that was when the reality of my diagnosis first set in. Prior to that, I had been functioning on adrenaline and kind of the super Jen character that, you know, I used to get through whatever I need to get through. In your case, I would recommend, if you have a double mastectomy, to do the tissue expander. Would you like to look at some pictures? Would that [INAUDIBLE] helpful to you? OK. Now these pictures are of all different types of people, different sizes of people. And I remember photos and discussing what would happen. And I was a mess. I cried my eyes out. I'm sure he thought-- I'm sure he didn't think anything, but I felt like I couldn't keep it together. But it was really important because that's when I was able to make some decisions. I was starting to put together information and able to take that information and make decisions that worked well for me. So after my surgery, I woke up in post-op. Actually, I don't recall that. I recall when I was in my room that I would then stay in for the next day or so. And I couldn't move my arms. And that's something that I hadn't put together that that would be the case, but it certainly makes sense. There's a lot of trauma to the body there. So that makes sense. Therefore, it was difficult to sit up. It was difficult to do much of anything. I also had drain tubes that were placed. And I'm sure that I had been told that. It's another thing to wake up and see it. And I think I was generally afraid of looking down at my chest. I think I was afraid to see something I didn't want to see. After being released from the hospital or discharged from the hospital, I went to stay with my sister-in-law so that I would have somebody helping care for me. I couldn't take care of myself. I couldn't lift my hands to reach into a cupboard. I couldn't lift anything. And when I first unbandaged the surgical site, I almost-- I almost fainted because the reconstruction had already been started. And again, intellectually, I knew this, but emotionally, I guess I wasn't prepared. And so I had somewhat of a breast. And my first thought was, oh my god, they didn't get it all. Not my smartest moment, but yeah, it was scary. But what they do, after the breast surgeon does the mastectomy, and not in every case, but in cases where you've determined already that you are going to do reconstruction, the plastic surgeon will then step in and go ahead and insert the temporary implants. What you do is you go in every few weeks or so and have injections into the temporary implants. They're called expanders. And they gradually inflate and gradually stretch your skin, because when they do the mastectomy, at least in my case, they removed a good portion of the skin and pull it back together. But then you slowly have to stretch that skin. They do that with the expanders over the course of several injections to the point where you're going to be the size that you're going to be. Sorry to be crass, but that's the way it is. And then eventually, after they've kind of settled for a while, I think it was after my last injection, so to speak, I think it was a few months until the time that I had another surgery to then swap the more permanent implants for the temporary ones. So after the surgery was done, I healed. I would go in and see the plastic surgeon a couple of days after the surgery and then maybe a week after that just to check on how things were healing, and so forth. And then probably a month after my surgery is when I started chemo. I had something called Oncotyping done, because I had many tumors. They sent two of them for Oncotyping. That helps determine what type of chemo would work best, and chance for recurrence. And my results came back showing that I was really kind of on the border. My oncologist said, you know, you really don't probably need to have chemo. But for me with the history of my niece, I wanted to do everything possible. So here's what happened. Jennifer had her surgery. And that's the most important part of therapy for any breast cancer or any cancer patient is to try to remove all the cancer that we know about. Problem with cancers though is they-- they're sneaky. You know, and even before people are diagnosed with a breast cancer, some microscopic cells might have invaded the surrounding tissue and then got into the bloodstream, and then-- or the lymph system, and then spread to a bone or an organ or something like that. And that's beyond the ability to really detect with labs or scans or anything like that. And so the important part of therapy happens. You remove everything that we know about. But if these microscopic cells that have already spread at the time of surgery, if those cells are not eradicated, or mertilized, annihilated, whatever, you know-- choose your verb there, you know. If they're not destroyed, those cells that have spread, they could grow. And over time they start to do stuff. And then Jennifer would get a symptom and she'd say, hmm, something's going on. She'd see a doctor. They would say something's there. They would biopsy it. They would look at it under the microscope. And they'd say, oh my God, Jennifer's breast cancer has come back. But the truth is, comes back should be in quotes, because it was always there at the very beginning. The reason why somebody after surgery sees a medical oncologist, the men and women who do what I do, is because we give medicine to try to eradicate those residual cells. And if we do that, we give patients the highest chance of cure possible. So before, way back in the 20th century, there wasn't a lot of great understanding of the biology of breast cancer outside of the fact that it was either estrogen receptor positive or not. But it turns out, so everybody got chemotherapy, or many people did based on their age or the size of the tumor. And that was based on the best thinking at the time, but we know now that that was very limited because we really treat patients now based on the biology of their breast cancer. And one breast cancer is not the same as another breast cancer. I mean, they're as different in their gene expression as snowflakes are, or fingerprints. So but it turns out you can kind of look at the biology of breast cancer and get it into various subtypes. And the reason why that's important, not just because it's just important to some pointy-headed academic, it's important because the therapy that we come up with to try to eradicate those residual cells is based on the biology of those cancer cells. So chemotherapy is something that we use now for cells that divide very, very fast. Chemotherapy works because it kills cells that divide fast, and cancer cells divide fast. So yea, it can kill those cancer cells. Problem is is that you have normal cells of your body that divide fast, too. And the chemotherapy will temporarily damage those cells. Those cells are more resilient than the cancer cells that we hope will just die. But you know, the follicles of the scalp, those divide fast, too. So people, when they get chemo, they'll lose their hair. That's a toughie for many people. I absolutely lost my hair. I lost most of my eyebrows and most of my eyelashes. Yeah. And I wore a wig because for me, I really wanted to be that woman who spoke up for breast cancer and was open about it in not wearing a wig, but I really didn't want people to feel sorry for me, or to look across the aisle at Target and not hear my story of how well I'm doing and assumed, assumed that I must be doing poorly or that I must be really sick. It was scary to lose your hair. Especially for women, I think. I mean, maybe I shouldn't say especially for women, but our hair and the way we look is a big part of who we are. And for that matter, losing your breasts. That's a big change in a society that focus-- focuses so much on these things. I had six sessions, and mine were three weeks apart, which was really nice. I was able to tolerate it physically because it wasn't, you know, chemo after chemo, which can be very difficult. But it was the entire summer that I underwent chemo. You know, when you start this process, you have so many appointments, and you've seen so many doctors, and you're being poked and prodded so many times that all you can think of is the day when you're not poked and prodded. And then that day comes and you think, what am I going to do? It's a safety net in a way. And I've talked with other survivors who've gone through that same emotion, feeling kind of like, you know, they're doing something. They're actively fighting the breast cancer. And it is scary to stop that, to feel like you're stopping that process, and to then move forward. And what does that mean? And how is that going to look? And what can I do? And it's scary. But it's the next step, and the further along you go, the better it gets. I've talked to other women who have been afraid to even do self-exams for breast cancer. Oftentimes, women who've had a mother who underwent breast cancer and back in the day, perhaps they didn't have a very good result, and now with these women today are afraid of going through that same issue. And therefore, they're not checking, and they don't want to get mammograms. And I-- I just want them to know that it can be really good, and you can get a really good result, and be really happy with how you look. You really can. I had no idea how I would come out of it. I had no idea if my life would ever be the same. We went the day before and had photos done, my son and I, because I wanted him to have something to remember that in case I never got back to that. But I feel that my life now is so much fuller and so much more blessed. I have a greater appreciation. I always did. I we've had a great appreciation for everyone I loved, and my family, and my life. But it's at a different level. Every moment is purposeful and filled with intention. And I've filled my life with things that I love. And none of us knows how long we have. And my focus in living each day is making sure that I'm the mom that I want to be, the friend that I want to be, the person that I want to be. So the new norm is good. My name is Jennifer and I'm a breast cancer survivor. [MUSIC PLAYING] Hey, it's Jen. I want you to go-- [INAUDIBLE]! [DISTANT SHOUTING]
Ine Amachree and her husband, Cephas Agbeh, share their story.
[MUSIC PLAYING] So he examined and he said, yeah. It looks like papilloma, because it's coming from one duct, not the whole duct. So I asked him. I said, OK, if you don't want to take it out. Because I'm not a surgical person, I don't like surgery. I don't like hospital. You know, the fear and everything except, what would happen if I don't do anything about it? Besides my incontinence. And he says, well we can't guarantee anything that this might change to cancer, or whatever. But I know that this is papilloma and this could be discomforting. So I thought about it, and then last year I called him and said, I'm ready. I think-- my husband kept saying go take care of it. Because every time it comes out, you know, you freak out about it. So go take care. So I called in. And at the time I told him that I had to go home emergency for a funeral. So he said well, if you're going out of the country, I'm not going to do anything about it. When you come back, call the office. Because after surgery, if something happens, I want to be here to take care of it, if there is an infection or anything. So go, and then come back. When you come back, call the office. So I called him, and he said OK. I saw you last six months ago. So I'll have to see you again before to see if things have changed, or whatever. So I went and saw him. And then he said, OK, we'll take care of it. And make an appointment. But before I do it, I like to have a mammogram to see what, you know, where you are. So I texted my husband, and told him, Don wants me to do mammogram. Because my mammogram office is different now. I mean, it's office. So then my husband text. I said you know, it's a very good idea you do a mammogram there. And don't worry about the health insurance issue. Do the mammogram, because then different people will look at your mammogram. And that way, if the results still come out to be the same, then you are short. So don't worry about it. So the nurse made an appointment with the mammogram department. And I did the mammogram. So I came home and everything and the result came up fine. Nothing was there. So we set up the appointed for the surgery, on May 10. So we went in the morning. Of this year? Of this year. 2013. Friday. So the surgery was at 7:00 in the morning. So we got there 5:45, I think. So went through the whole thing, and he came, he's a sweet guy. Saw me and the nurses and everything. So he said well, if everything goes well, you will go home. So I said, OK. So everything went well, and about 10:45 we left the hospital. And went back home. And then about 1:45, Dr. Don called. So I answered the phone, and then he says [? Eni. ?] I said yeah. He said, in his voice I could tell something was wrong. He said, I have good news, and I also have bad news. So I said, OK. So he said well, the pathology report, the lab reports say that it's cancer. That's the bad news. The good news is it's very tiny. It's very small, and it's very treatable. So at that point, before your eyes your life has changed right away. But you don't have emotions. You are confused. Could this be true? And he's like, are you there? It is very treatable, is what he kept saying. It's almost like he wants to write it in my head. It's going to be OK. It's treatable. And I'm saying, he must be dreaming, you know? And finally I said, OK. And he said, we'll make an appointment. You come back and see me. We'll go back in, and we'll do it. So I told him, I said, I am the child of God. Cancer can never exist in my life. So he said, OK. Hold that thought. But all this while, my mind is still racing. How did this thing find me? Could this be true? What is 1.5, and then the hospital says one point. Besides that, and then I started thinking, OK. If I had done the surgery last year, when I was postponing, it could have been found. So you go through the emotions, and then you see your mortality right away. Because everybody who hears about the c-word, always think about death right there. That's all you think about. So you think about kids, your husband, and you go up and down. So now we come back to do the MRI, and the biopsy. So during the ultrasound, of the lymph nodes, Dr. Trombley comes in. And she looked at my report, and everything, and then she started and she says, oh. I'm going to try and see what MRI is seeing. If I find it on the ultrasound, I'll do your biopsy here, so that you don't have to go to MRI, and suffer that. So I said OK. So she checked, and checked, and checked. And she said I can't see it. But let me go ahead and do the lymph nodes, that is light enough, first. Take that out of the way, and then we'll go and search. So she went ahead and did the lymph nodes. And then she came back searching and searching. She looked at me. Said you can take a lot of pain, huh? So I didn't answer. She finished, she said I can't see it what the MRI is speaking of. I can't find it. So I'm sorry. You will have to go back to MRI and do the biopsy downstairs. So I said OK. So I lifted up my head, there was Dr. [? Trump, ?] again. So I felt very comfortable at that moment. And she said, we've done so much to you. Today we poked you too much. Go home and rest. You'll be all right. So I said OK. So I came back and my husband was with him, and I told him, I said god has a purpose for this. Because each one that I have met, it's so wonderful they don't make me feel they were physicians. They made me feel they were humans, and they can feel. So we'll be right. And he said, I told you we will be OK. So we came home, and then his team is still trying to find a way to define what this cancer is to me. And then he said to me, said [? Eni, ?] there is no such thing as good cancer. There's no such thing. Cancer is bad. But if there is any that anyone would consider a good cancer, then that's the one you have. Why don't you hold onto that? So I turned around and I said, what do you mean good cancer? Is there a thing like that? I also went to school, don't forget that. There's no such-- he said no. That's what I mean. There's no such thing. I'm trying to let you see that if found early, something can be done about it. For me, it's-- I have to be strong for her. And the kids. I have my own moment. But I think if I fall apart, that makes it very difficult for everybody else. But we are where we are, and we're just very thankful that this has been found, hopefully, early. And at the same time, come to some realization that you can use this opportunity to probably educate other people, give them some realization that this is not something to be afraid of. At least the health care system is not something they should be afraid of. Knowledge is power. The more you know about your own specific circumstances, I think is more helpful. Yes, she said anyone who hears the word cancer [INAUDIBLE] means you're going to die. It doesn't necessarily mean so. It all depends on when this was found, and hopefully it's found early. So the trick is how does it get found early? And we are lucky, just like Dr. Don said. So we're ready to face treatment. So that's where we are. Finally meeting people who have gotten breast cancer and have survived, for just a couple of years, plus 20 years over, makes it real. As opposed to just hearing about this person got cancer and passed away. So having known all this over all these years, I never knew. So that's been a good healing process for her. And I think that's what she meant by that made it real for her. So that's been our support system. And I think that's the-- if you call it conquering fear, I don't think I'll be able to conquer it until I go through my surgery. Because that's a big fear for me. The OR. But what he said, knowing people who have been through it, and have survived it, the people, when you get the news the people you know. We know people who have died of breast cancer that are very close to us. Friends here in this country. So when you get better results, or when you get that phone call, your mind automatically goes to those who have passed away from the disease. So he had to remind me constantly, and said Enid, you do not know this stage at what they were discovered. The people, you know, friends of ours that may have died. We don't know when they discovered them. So you can't use that to think about yours. So I said, OK. That makes sense. So when I started talking to family members of the friends that passed away, I realized they were the third and fourth stages when they would discovered. So then when I saw these women who come up to me to say I'm seven years, I'm 20 something years, and yesterday a lady she's in her 70s, her mother had it 1934. When she was five years old. And the mother said, my mom lived to be 80 something years old, and was describing how the mother got dressed and all that. Then it started making sense, you'll be OK. People have gone through, have walked it. You will be OK, too I knew some people who are not comfortable to go to a particular health group that they go to, because of the way they will be treated, or looked at. So they're like, oh forget them. So we need a lot of info. Us? No. We are not afraid of the health care system. Take our appointments, or keep the appointment, but we know quite a few people who are afraid. In conversations, in social [INAUDIBLE], you can feel that thick air. And you say to yourself, there's always that fear of unknown. But if you get through it, and go directly to the problem, you'll find out that we're all the same. What you were afraid of was really not existing. That's something you have to preoccupied your mind with. And there are realities to it, but everybody can be what you think. You just have to go and check yourself out. And even some will not go, because they are afraid, they expenses. So they won't go for their annuals, because something else is more important than the annuals. And so they might miss that. And then you tell them, you still go. Get it done. And then slow and steady, you can pay. But if you don't, what you're doing may not be on the top of your list when you find out that it's something worse than that. So. One more thing I just want to say is you never know where your support system is going to come from. And she probably thinks I'm very supportive. But from my point of view, the outside church people that she spoke to did more for her than all the reassurances I tried to give her. So when human beings get this kind of news, we just want to internalize it. And the lesson is maybe it's good to share with somebody, because you might get to share it with someone who has had similar experiences, who can be very reassuring to you. Because you don't know where your support system is going to come from.