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Celebrating science and self-advocacy in marking my ten-year breast cancer “cure” milestone

Betsy Bassan

 

Breast cancer has shaped my and my family’s life for at least three generations. What I learned from this family history of cancer is that each of us must be our own best advocates – as early detection detectives and empowered voices with our health care workers. We also must be ever grateful for the medical advances that make treatment options and survival rates better each year.

My mother’s breast cancer story. My mother was diagnosed with breast cancer when I was two and died shortly after I turned four, on Jan. 4, 1958, just shy of her 41st birthday on Valentine’s Day. Surgery and steroids were the key treatment options in those days: radical mastectomies, where the breast and a lot of surrounding tissue and muscle were removed, while patients gained curves elsewhere via weight gained from the meds.

Unfortunately, surgery didn’t come soon enough as the cancer had already spread. Over a long and painful couple of years, the cancer spread further, slowly debilitating my remarkably vibrant mom, who eventually became bedridden and then the unimaginable happened – she died.

She left five kids ages 4 to 11 and my dad, a doctor who never fully recovered from his grief of losing her and his guilt of failing to save her. He soldiered on. We were fortunate that we could afford the household help needed to care for so many kids. And our dad’s intense interest in life kept us busy exploring the vast playground of Washington State from our hometown in the Emerald City, Seattle. Still each of us have our individual lifelong scars from losing our mom.


My breast cancer story.
The prospect of breast cancer hung over my head throughout my life like Damocles’ sword. I labored under a foreboding sense that it could strike at any minute. My greatest fear was leaving my three kids without a mom, forsaken to repeat my family’s experience. This fear was so great that my mind would stop processing as soon as the topic arose. Amazing as it now seems, my gynecologist never suggested genetic testing to see what my real risk was.

One thing that did resonate was the need for regular breast self-exams, possibly a result of a graphic breast self-exam demonstration in college in which the demo breast was lovingly, but quite embarrassingly, called “Betsy breast.”

Besides regular mammograms, I kept a plasticized set of breast self-exam directions on my showerhead, trying my best to track a monthly course. In the shower just home from a business trip to the Philippines in October 2007, at age 53, I found a lump deep in the lower part of my right breast. My internist quickly got me into a surgeon’s office for a biopsy. My fear was incalculable. My very kind surgeon said he didn’t think the lump felt like cancer. I was convinced otherwise and unsurprised when two days later he told me it was indeed cancer.

Thus started a whirlwind of tests to nail down the specifics of the tumor and chart a treatment plan. I started out believing I had been given the same death sentence as my mom. But times had changed and, over the course of a battery of tests, my doctors plotted a promising plan of surgery, chemotherapy, and radiation. I have many heroes from those few weeks. Once I knew I would live, I was able to share my situation with my three kids.

I learned that I had a 4 cm “triple negative” tumor and that I carry the BRCA genetic mutation that makes breast and ovarian cancer almost inevitable. Triple negative had a particularly horrible ring, consistent with the aggressive growth that brought it to golf ball size only six months after a clean mammogram. My last mammogram was even double-checked and its “cleanness” reaffirmed.

Through breast self-exam, I caught the cancer before it spread beyond my breast and into my body. One of my doctors literally did a two-step when my PET scan showed the cancer had not spread outside the breast. I have no doubt that breast self-exam saved my life.

We removed the affected breast immediately and I likened myself to the Greek Amazon women who, like the Sagittarian that I am, shoot arrows better without that right breast getting in the way. While arduous, I cherished the life-saving miracle of chemotherapy and radiation, visualizing a magic elixir flowing through me doing battle with any little cancer metastases it ran into, while mentally traveling to my happy place in the Olympic National Rain Forest.

People with triple negative tumors are most at risk for a reoccurrence in the early years. Over the years, the risk declines, plateaus, until finally, at year 10, one is declared “cured.” I am deliriously happy to arrive this October 22nd at that milestone. Because of my genetic mutation, my doctor at Georgetown Lombardi Cancer Center is only graduating me from semi-annual to annual appointments. Whew. I also go to my onco-gynecologist annually, mostly to check that the inevitable ovarian remnants aren’t having any morbid tendencies.

Every day — and I mean every day — I give thanks for the advances in medicine and my own prevention efforts that saved my life so I can be here for my kids.

My daughter’s story. After experiencing firsthand the importance of early detection and equipped with an understanding of the BRCA genetic mutation, I’m having my children tested as early as possible. Each has a 50/50 chance of inheriting it. One was spared, one tested positive, and one is yet to be tested. The one who tested positive is enrolled in a special intensive screening program.

While a difficult discovery, we all feel deeply grateful that research and medicine have progressed to a point where, in our family’s journey with this genetic mutation, our children’s generation can be spared an early, painful, and sad death like my mother, and probably also the harsh treatments of chemotherapy and radiation. Rather, our child knows the risk and proactively is taking the steps needed to ensure a long, healthy life.

Meanwhile, treatment options continue to expand. All in my lifetime.

My mother, Celeste Franklin Bassan, wearing the breast cancer symbol, before it was even invented.