It Could Happen to You

by Meryl Neiman

I'm sorry. This post isn't about writing or my former day job. In fact, this post has nothing to do with crime fiction. It's about my sister.

My oldest sister lives in San Francisco. She's a partner at a large law firm. She loves to bike, ski, hike and travel. She's single. She'll turn 45 at the end of this month.

Last week she was diagnosed with breast cancer.

My mother is a breast cancer survivor. My grandmother and great-grandmother also had breast cancer. Every year when Jill asks my mother what she wants for her birthday, she tells her to get a mammogram.

Prior to her diagnosis, my sister hadn't had a mammogram in FOUR YEARS. I don't believe it was because she was scared. I don't believe it's because she has large breasts and the procedure is uncomfortable. I believe it was simply a matter of time. She never seemed to have enough of it. She works hard (too hard) as a lawyer and just couldn't get around to scheduling an appointment.

Jill was scared to tell my parents. Scared of their reaction. So I volunteered for the job. It was the hardest phone call I ever had to make. My mother said, "how could this have happened?" And her next sobbing question was, "how long has it been since she had a mammogram? What made her go see the doctor?"

I had to explain that Jill noticed her breast getting larger, as she put it, a few months ago. She eventually tried to get an appointment with her ob/gyn, but they couldn't schedule her for several months. (She didn't explain the nature of her problem.) Finally, she went to see her primary care doc who sent her immediately to see a surgeon. He told her upon examination that he thought she had cancer and performed a biopsy.

There was no palpable lump. Jill thought maybe she was just gaining weight. The radiologist who performed the mammogram at the surgeon's request opined that she had inflammatory breast cancer. As an internet junkie, I had arrived at that same disturbing hypothesis myself.

If you've heard of inflammatory breast cancer, you are in the minority. It's a rare, but aggressive and very lethal form of breast cancer. It frequently goes undiagnosed or misdiagnosed and because it spreads so quickly, that loss of time can prove deadly. Up until a few years ago, the disease had virtually a 100% mortality rate. That has improved greatly and there is some treatment, but women need to be vigilant.

Spread the word. Here is what to look for.

As the National Cancer Institute states, "Symptoms of IBC may include redness, swelling, and warmth in the breast, often without a distinct lump in the breast. The redness and warmth are caused by cancer cells blocking the lymph vessels in the skin. The skin of the breast may also appear pink, reddish purple, or bruised. The skin may also have ridges or appear pitted, like the skin of an orange (called peau d'orange), which is caused by a buildup of fluid and edema (swelling) in the breast. Other symptoms include heaviness, burning, aching, increase in breast size, tenderness, or a nipple that is inverted (facing inward). These symptoms usually develop quickly—over a period of weeks or months. Swollen lymph nodes may also be present under the arm, above the collarbone, or in both places. However, it is important to note that these symptoms may also be signs of other conditions such as infection, injury, or other types of cancer."

IBC usually does not show up on mammogram. Often women (and sometimes their doctors) think they are suffering from mastitis (a breast infection) or some other condition.

My sister's breast was just large. She didn't have any of the symptons.

As it turned out, she does not have IBC. That's a relief. However, that means that she could have caught her cancer MUCH earlier had she gone for regular mammograms. And she certainly should have seen a doctor immediately when she noticed a change in the shape of her breast.

She has a LARGE tumor and will need to endure chemotherapy before surgery to reduce the size. She has not yet seen the oncologist, but her surgeon has told her she has stage three cancer.

She's young and healthy and I hope will pull through this. But it shouldn't have gotten this far.

I urge you all to tell your female friends and family about IBC. One mother of an IBC patient stops strangers on the street to spread the word. And ladies, schedule your mammograms now!