When the BC Cancer agency approached Colleen O'Neil to get her friends together to film a commercial about mammograms, she responded positively, and invited her friends to meet her at Diane's Lingerie shop in Vancouver. The premise was a party to support women who'd lived through breast cancer and surgery, the camera crew was an add-on, and supposed to be a surprise.
"I wasn't entirely on board with surprising my friends about such a serious topic," says O'Neil. "But I think it's important to emphasize the importance of mammograms."
Islanders who saw the commercial on television may have recognized O'Neil, as well as Shari Ulrich and Jane Kellett. However, O'Neil said she wanted to shelter her friends, especially those who had personally experienced breast cancer, and another group of women provided the focus for the commercial. Still she says the topic needs to be broached because mammograms save lives, and a routine mammogram at age 53 saved hers.
"When it came to breast cancer I felt bulletproof, I had no family history. It's recommended that women over 50 get mammograms every two years, so that's what I did. When they found cancer in my breast, there were already three lumps and I had to have the whole breast removed. I often wonder, if I had not skipped a year between mammograms, maybe I could've gotten away with a lumpectomy instead of a mastectomy."
O'Neil says what did appear in her mammogram looked like grains of sand and would never have been detected through a breast exam.
O'Neil is just one of a handful of women on Bowen who have survived breast cancer, and who were diagnosed because of mammograms. O'Neil and three others gathered at Caring Circle to talk about their experiences.
Mary Letson says that because she had a family history of breast cancer she was diligent about getting mammograms every year after the age of 45.
"For my first three mammograms, I wasn't afraid. But I'd heard about a number of friends who had been diagnosed recently and when I went last year to the mobile screening clinic set up in Dr. Zandy's office, I felt something very different."
Letson was diagnosed last August at age 49.
"The cancer might have been in my breast when I'd had the previous year's mammogram, but it wasn't detected. By the time it did appear, it was already in my lymph nodes which is why I needed to go through chemotherapy."
Despite the fact that the cancer had advanced beyond her breast, Mary says there's no way she could've felt any kind of lump.
Sam Knowles was 43 when a routine mammogram showed a few "areas of concern." Further tests, an ultrasound and a biopsy, revealed pre-cancerous cells in her breast. The removal of those areas of Sam's breast, and the pathology that followed, revealed ductal carcinoma in situ, the most common and most treatable form of breast cancer. While this form of cancer is usually treated by lumpectomies and radiation, Sam ultimately required a full mastectomy.
"I would never say to someone that you have to go get a mammogram, but if you do have breast cancer and get a mammogram, you might not have to go through treatment that's as invasive, and I'm living proof of that," says Knowles, adding that while the cancer had spread to her whole breast it did not spread to her lymph nodes so she did not have to endure chemotherapy.
Cathryn Robertson had already lived through the diagnosis and treatment of cancer in her right breast when, eight years later, a routine mammogram highlighted an area of concern in her left breast. Robertson's doctor sent her for an ultrasound to follow up the mammogram, which did not turn up anything.
"The doctors said, don't worry about it, and then, six months later I could feel a small lump, and that progressed to a burning sensation in my arm. The doctor sent me for an ultrasound which revealed a tumor they said was one centimetre, but when they went in to remove it they found out that it was actually five centimetres!"
After two lumpectomies, there was still cancer in Robertson's left breast and she was told that she would need a mastectomy. That surgery revealed that the cancer had spread into her lymph nodes and led to the diagnosis of "stage three cancer" treated with chemotherapy.
Robertson says that if she were to go back in time, she would've demanded a biopsy following her "false positive" mammogram.
"It's important to trust your caregivers," she says, "but you also have to be your own advocate. There are people who say you shouldn't get a mammogram because they turn up false positives. These people are not looking at things the right way, take the false positive as a gift, someone is looking at your breast and is concerned. It's an opportunity for you to take care of yourself, and if the result is in fact false, then it is a very good thing."
The anxiety caused by mammogram results considered to be "false positives" is one of the reasons for revisions to mammography guidelines in British Columbia that recommend women under 40 who have an "average" risk of breast cancer only need to be screened every two years. While experts are split over whether or not this change is for the better (O'Neil points to two Vancouver radiologists who treated her and have differing opinions on the matter) what is not disputed and what hasn't changed, is that mammograms have cut death rates from breast cancer by about one-third. Colleen O'Neil, Mary Letson, Sam Knowles and Cathryn Robertson all insist, that the benefits delivered by mammograms outweigh the risks and fears that go with them.
"Mammography is how we are not dead," says Colleen O'Neil. "There is one study from 30 years ago, that was flawed to start with, that keeps getting resurrected and publicized, diminishing the importance of mammography. But the fact is simple: early detection leads to cures."
While Knowles says she would never tell someone that they have to get a mammogram, when she hears that mammograms are risky, or don't work, it makes her angry.
"We've lost too many women to breast cancer on this island already," she says.
All the women agree, that the journey through diagnosis and treatment is terrifying. The women also agree that, iving on Bowen, they were able to find the support and resources they needed to help get them through, and they say they hope other women facing breast cancer will reach out and find them.