To why haven't you had a mammogram yet?"
The question lingered for a minute in the chill of my new gynecologist's office while I tried to come up with something other than "because I'm terrified."
After stuttering something about having had a baby and putting it off, she told me it was time to get it done. The staff is pretty wise at this doctor's office. The nurse faxed the order for the test right to the hospital's scheduling center, leaving no chance I could stuff the order in my purse and watch it slowly erode into pieces from spilled juice and melting M&Ms.
Those three weeks waiting for test day-and the subsequent few days waiting for the results-were an interesting and sometimes frightening odyssey. I was forced to think about things I was good at shoving aside while juggling four kids, a husband and a job.
The one unavoidable cold, hard fact is that we all know someone who has been affected by breast cancer. There are the famous-Sheryl Crow, Melissa Etheridge, Kylie Minogue, Olivia Newton-John, just to name a few-and the not-so famous. It could be your neighbor or the mother of your child's classmate or the woman whose face you see on a flyer for a benefit to help pay her medical bills. Almost always, those women are shown with their kids.
In my own life, my mother-in-law was diagnosed decades ago in her mid-30s, with two young boys to care for and at a time when the odds of survival were stacked against her. She's a healthy woman in her 60s today, but the scars still linger, both visible and invisible.
According to the American Cancer Society, breast cancer is the most common cancer among women, except for non-melanoma skin cancers. The chance of developing breast cancer is about 1 in 8. About 178,480 new cases of breast cancer will be diagnosed among U.S. women this year.
There are some theories about prevention, such as cutting down on fat and exercising more, but even the healthiest woman can be hit with the disease. While it is not perfect, mammography is the most predominant screening tool for breast cancer and, most importantly, it does save lives.
The American Cancer Society officially says women should begin getting screening mammograms every year, beginning at age 40. The American College of Obstetricians and Gynecologists goes a bit further, recommending that women undergo at least one baseline screening mammogram between 35 and 40, which is where I fit in, then annually at 40 and older. Illinois law mandates that insurance pay for the baseline screening between 35 and 39 and annual screenings at 40 and older.
So knowing without question that early detection is the best chance at survival and that a mammogram is the best chance at early detection, why are so many of us so scared?
For me, the answer was the most irrational one possible: "What if they find something?" Yes, I know (and my husband reminds me often) that it would be better to find "something" now rather than later. But I come from a long line of people who believe what you don't know won't hurt you.
The truth is, I knew I had to get the mammogram.
As moms, we have a responsibility to take care of ourselves, not just our families.
At long last, the day of my mammogram arrived. It was strange for me to be going to a hospital for something not baby-related. With 10 years of ultrasounds, blood tests and four deliveries behind me, it seemed like I entered a new chapter of my life.
I did not do anything special to prepare, except quit drinking caffeine the week before the exam. Some doctors say it doesn't matter; others say it can cause you to retain water and show false positive results. I wasn't taking any chances.
I checked in and was led to a changing room with lockers for my clothes. When I put on the gown and walked to the next waiting room, I noticed an Arab woman and her daughter waiting together. We gave each other the same knowing smile, and I thought to myself that here is one place where women are united, no matter what your politics, race or ethnic background.
Within minutes, my name was called. My first thought was that the machine did not look anything at all like I was expecting. It was about the size of the large machine they use at an optometrist to check your vision, the one where you put the lenses over your eyes and tell the doctor which picture is the clearest.
The technician introduced herself as Julie, shook my hand and gave me the same speech I'm sure she's given many times. I would get the exam, she would make sure the images turned out, a radiologist would read them and I would get a phone call by the middle of the next week if there was a problem.
We went to the machine and first she put cute little flower stickers over my nipples. Then she pulled my breast onto a small tray and attached something to grab the skin so the breast could be flattened and X-rayed.
I had to stand very still and not breathe while she did the photographing, which took about 15 seconds. Next I was told to put my arm over the machine and lean in so she could get the underarm, too. That felt a little more like gymnastics to me, but it was over before it became too intense.
At no time, even leading up to it, was I ever afraid it would hurt too much (four deliveries, remember?) and it honestly did not hurt beyond a little pinching.
Once we were done, I sat for a few minutes while she made sure the film was good, then she told me I was free to go.
That's when the panic set in.
For some reason, once I sat down to relax that night, I became fixated on the fact that Julie did not look at me when she said I was free to go. The more I thought about it, the more I was SURE her demeanor had changed. I just knew she saw something on the films. I went from being OK to being sure that she was thinking about me as this poor mom who was about to get the worst news of her life.
I will be brutally honest: I drove my husband and myself crazy for the next four days. Doing laundry, I wondered if my husband could handle all of it on his own. Playing with the kids, I feared how their lives would change without me.
And then there's the Internet. I found statistics. Plenty of statistics. Most comforting, I learned that 5 to 10 percent of mammogram results are abnormal, but the vast majority of those turn out to be non-cancerous. I fought the "what ifs" as long as I could.
Five days after the mammogram, I couldn't take it any longer. I called my gynecologist under the guise of asking how I'd get results. Finally, I confessed to her (on my cell phone on the train, no less) that it was my first mammogram, I was really nervous and I hadn't slept well in days. Could she please check for me?
I can say, without question, that I have never in my life said so many Hail Marys so fast as I did during the time from when she put me on hold until she came back and said, "I have the results and they are stone cold normal."
The obvious lesson here for me is that I did what I had to do and it was fine.
The deeper lesson is that the mid-30s to early 40s-the post-baby years for many of us-are a real transition for women.
The reality is that my friends and I are talking less about fertility methods, epidurals and diapers and more about mammograms, cholesterol tests and wrinkle treatments. It's a reminder that our bodies are aging and the time to take care of them is now.
I won't say I've kept every frantic resolution I made to myself during those days of waiting, promising to eat only fruits and vegetables and exercise daily. But I have realized that if I don't take care of myself and my health, then the "if onlys…" that I fear so much will haunt me down the road.
New recommendations fuel discussions
MRI scans for at-risk women
The American Cancer Society in April recommended women with an especially high risk of developing breast cancer should get magnetic resonance imaging scans along with their yearly mammogram. For women at average risk, the American Cancer Society still recommends getting annual mammograms and breast exams by a physician, beginning at age 40. Most high-risk women should begin getting MRIs and mammograms at age 30, the new guideline says.
Risks vs. benefits of mammograms
Women between the ages of 40 and 49 should better understand the benefits and risks of screening mammography, according to the American College of Physicians' new guidelines announced in April. The main benefit of screening mammography is a decrease in breast cancer deaths, while the risks include false-positive results, possible treatment for lesions and radiation exposure, says the ACP, the nation's second largest physicians group.
Jacqui Podzius Cook is a magazine editor who lives in Oak Lawn with her husband and four children.