ó When Beth Stewart was 36 years old, she felt a
pebble-sized lump in her breast.
Odenton mother of two was healthy and active and had no
immediate family history of disease or common gene mutations
ó but she had advanced and aggressive breast cancer.
said to my oncologist, ĎWhy?í He looked at me and said,
ĎI hate say this, but itís bad luck. We donít know why
this happens to people like you.í But it happened and it was
a really hard thing to go through."
donít know why many women get breast cancer, the most
commonly diagnosed cancer after skin cancer, according to the
U.S. Centers for Disease Control and Prevention. Nearly
233,000 people are expected to be diagnosed with the disease
this year, and 40,000 are expected to die from it.
eight women will be diagnosed in her lifetime.
biggest risk factor is just having breasts," said Dr.
Regina Hampton, a breast cancer surgeon and medical director
at the Comprehensive Breast Care Center at Doctors Community
Hospital in Lanham, Md.
are learning more about risk factors. CDC and other federal
health data shows family history accounts for about 15 percent
of cases, and mutations in the BRCA genes are responsible for
up to 10 percent. In about two-thirds of cases, the women are
55 or older. Fewer than 5 percent are younger than 40, like
smaller risk factors include early periods or later
childbearing or menopause. Women taking hormone replacement
therapy after menopause were linked to higher rates of cancer,
so there has been a decline in that treatment.
Hampton said advances in diagnosis, such as 3-D imaging, and
treatments that target specific kinds of cancer mean the death
rate has been declining for decades.
invasive surgeries and better reconstructive technique
immediately after cancer surgery also enable women to retain
or regain their physical appearance, she said.
there are new tests in the works, including one that checks
for many gene mutations that raise a womanís risk of cancer.
That will allow doctors to closely monitor those with the
mutations, Hampton said.
women avoid doctors, especially in immigrant, Latino and
African American communities, apparently because of common
beliefs such as that breast cancer is always fatal or surgery
can expose tumors to air and cause them to spread, Hampton
delays in treatment have contributed to a disparity that
Hampton has been working to close through her private practice
called Signature Breast Care. White women are more likely to
be diagnosed with breast cancer, but black women are more
likely to die from it. Black women also are more likely to
have so-called triple-negative cancer that doesnít respond
to the latest medications.
need to do your self-exams. You need to get mammograms on
schedule. If you have a lump you need to be evaluated,"
she said. "You can survive the disease. We treat it so
Shaw, a 32-year-old African-American mother of three, was one
of Hamptonís patients who got the message. She had been
doing her self-exams regularly since she was 18, when her
grandmother was diagnosed with breast cancer.
found a pebble-like lump, she headed to her doctor. When
breast cancer was confirmed, at Stage 2 and confined to her
breast, she sought information on her options. She opted for a
bilateral mastectomy, though research shows no greater
acknowledged it was a radical decision influenced by her age.
Shaw was diagnosed once and feared a second, unrelated tumor.
cancer free after surgery, she said she felt lucky to be
surrounded by her mother, siblings, children and church
family, though she separated from her husband after the
diagnosis. Shaw now feels driven to espouse the benefits of
became passionate about telling women to do self-exams,"
she said. "Go to the doctor and get checked out. Donít
assume this and that, and donít wait until it spreads."
thing Shaw and others said was difficult to prepare for in
advance was the diagnosis.
normal, said Dr. Diana Griffiths, medical director of Saint
Agnesí Breast Center in Baltimore. Even though many women
know someone with the disease or hear about celebritiesí
cases, "There is always an element of surprise. Itís
out there but people think itís not going to be me."
worries that fear of bad news puts off many women from getting
mammograms, though she agrees that treatments are so good that
most women have multiple options and good outcomes. Griffith
said the Saint Agnes center makes sure women are able to make
women end up being pretty rational and want to fight
things," she said. "Iím forever amazed by the
courage and clarity of what women want to do."
said most continue to work, care for their families and, while
they didnít want cancer, many even discovered different
meanings to their lives.
who manages a software engineering team for the federal
government, said her family became more of a focus. And so did
had gotten back into the sport when she was diagnosed. She
used it to exorcise her anger at having the disease, to make
her feel better in between chemotherapy treatments and to
focus her attention on something positive.
completed several distance races so far and planned to run in
a half-marathon with her husband. Her two daughters, now 5 and
8, also ran shorter races with her.
world doesnít stop because you have a scary diagnosis,"
told myself: You have a family and a full-time job and kids
who need you," she said. "I needed to look forward
and feel strong, and running helped me do that. Iíd much
rather worry about runnerís knee than cancer."