After enduring many mammograms over the years I recently had my first digital breast tomosynthesis also known as 3D Mammography. Mammograms are always scary, the squishing and pain and waiting for results. Fear is heightened as all of us live under the cloud of national statistics -- one in eight women in the United States will develop breast cancer in her lifetime.
This message about the urgency of early detection will be amplified during October, which is Breast Cancer Awareness Month.
My anxiety during the screening was soothed by the warm purple light emanating from the frosted Plexiglas machine. I was also comforted by knowing that this 3D procedure takes a more detailed set of pictures.
Dr. Eva Duckett, director of breast imaging at Chesapeake Imaging Center, where my procedure took place, sits down with me and explains that "all looks good," as she flicks through multiple images of my breasts on the computer screen.
"Think of that stack of compressed breast tissue like a deck of playing cards," Duckett said. "With the older mammograms, we are looking at the stack of compressed breast tissue at once, trying to determine if any bad cards are in there. Now with the 3D imaging, we are looking through that tissue, layer by layer. We can catch more tumors, particularly in dense breasts, that could have been hiding in previous scans."
"We recommend annual screening" added Duckett. "The doubling time for tumor cells is about six months and some tumors grow faster than others. Skipping a year makes a huge difference in early detection."
In my research compiling "Sex After...Women Share How Intimacy Changes As Life Changes" I had the opportunity to speak often to breast cancer survivors. And while their stories vary, I am struck by their similarities. They are all courageous and have learned the hard way that it is the mind and spirit and not the body that compose a woman's central character.
This, when breasts have been glorified, worshipped and sexualized throughout history -- from sixteenth century Rubenesque nudes and the perky boobs of Marie Antoinette to the modern-day cleavage of Sophia Loren and the curvy Christina Hendricks who played Joanie on "Madmen."
One survivor I interviewed, recovering from a mastectomy and treatment for Stage Three Type B invasive breast cancer, said her medical journey was "a nightmare at first -- as I was stitched up like a rag doll." But forging onward through the maze of treatments, she began to feel more womanly than ever.
"I was like the Warrior Woman after my surgery -- I took up running and spinning and had this self-image of being really feminine and really strong," she said. "I got really fit, I loved that, and so did my husband. Surprisingly, he was very turned on by my warrior spirit."
Her tumor was caught late and missed on a standard mammogram. She found it in a self-examination when it was already larger than a marble, and lodged in her chest wall. With advanced 3D imaging this cancer would have been detected in its earliest stage.
"Many cancers we find today would have been invisible years ago," says Dr. Mark Baganz, owner of the dozen Chesapeake Medical Imaging centers in Maryland. "We are hoping that the 3D mammogram becomes a standard procedure. The science is so supportive."
He points to the result of a study published in June of 2014 in the Journal of the American Medical Association that sampled nearly half a million patients -- the largest study on digital breast tomoysnthesis known to date. The results demonstrated a 41percent increase in invasive cancers detected with 3D mammography and a 29 percent increase in all breast cancers detected.
After two decades in practice, breast surgeon and oncologist Dr. Lorraine Tafra has seen the full range of cancers, contained and aggressive. She is founding director of the Breast Center at Anne Arundel Medical Center in Maryland, a state with a high breast cancer rate.
"It has been fascinating to me as a surgeon to observe how different each woman reacts to the diagnosis of breast cancer," Tafra told me. "Some women make it very clear that their breasts don't mean that much to them. They have a small tumor in one breast, and they want them both off, quickly. They tell me, 'I never really liked them anyways'."
Most women now want reconstruction right away, but again, Tafra says she sees a wide variance in patients. And their responses have little to do with age.
"There are women in their 70s who tell me: 'I can't wake up without breasts! Get those plastic surgeons to work right away!' And there are young patients who may be athletes who have no interest in reconstruction, a process that requires more healing.One patient, a professional soccer player, was happy to be rid of her big breasts. They slowed down her game."
The promising news as we enter Breast Cancer Awareness Month is that with early detection and advancements in treatment patients who present with small tumors and no metastases have upwards of a 95 percent survival rate. They get to watch their children grow up and get married and become a grandparent, like Terry Rubin, a two-time cancer survivor.
While Rubin, 61, credits her doctors for extraordinary care, she says the most important boosts toward healing came from her own "spiritual reservoir" and the unwavering devotion of her spouse.
"I could not have done this without my husband, with whom I have one of the most intimate marriages of anyone I know," Rubin said. "True intimacy is that recognition of your partner's spirit and soul. And while you have the gift of deepening that intimacy through sex, the heart of true intimacy comes during those moments in life when you get to be authentic and vulnerable with each other. Cancer definitely puts you into that very real place.
"Some partners would have been turned off to be with someone who has had as many physical changes as I've had," she continued. "My breasts after mastectomies are scarred, and when I was going through chemo I looked sickly. Your partner during this process has to be somebody who is a soul mate. Today I feel like a million bucks. And much of that comes from a connection with a partner that goes way beyond the physical body."
Read about Iris Krasnow's books on intimacy and relationships on iriskrasnow.com
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