I am 39 years old, and many of my millennial friends have had breast cancer.
Some were diagnosed in their 20s. They were fortunate to be able to work with genetic counselors and fertility specialists about their intended family planning and now have children. Some were diagnosed after 40; their kids may or may not know about their health scare depending on how their moms chose to handle communicating about it.
Some, like my friend Robyn Grosshandler, were diagnosed in their 30s shortly after giving birth. “If you feel something is off, don’t get dismissed or tell yourself your breasts are just different due to hormonal changes or nursing. You deserve to be heard,” Robyn encourages.
My friends’ real-life experience is reflected in the latest statistics, as breast cancer rates continue to rise among young women. Fortunately, the death from breast cancer rates are lower than they have been. That is largely due to improved screening and treatments.
I recently got screened myself. In honor of October being Breast Cancer Awareness Month, and because I knew little about what to expect and like to empower other women with awareness so they feel less alone, I am sharing my screening story.
The American Cancer Society currently recommends the following for women with average risk for breast cancer (i.e., no personal history of breast cancer, no strong family history of breast cancer, no genetic mutation known to increase risk of breast cancer, and no chest radiation therapy before the age of 30).
- Women between 40 and 44 can start screening with a mammogram every year.
- Women 45 to 54 should get mammograms every year.
- Women 55 and older can switch to a mammogram every other year or choose to continue yearly mammograms. Screening should continue as long as a woman is in good health and expected to live at least ten more years.
As of last month, the Food and Drug Administration (FDA) requires that all mammogram reports sent to patients must include breast density information since women with dense breast tissue have a higher risk of breast cancer. If you do have dense breasts (like I do, as do nearly half of all women 40+ who get mammograms, according to the National Cancer Institute), you are encouraged to speak to your healthcare provider about additional potential screening options, like an ultrasound and, if needed, a biopsy.
To get my screening, I had to jump through a few unexpected hoops that, I believe, reflect a healthcare system that needs to be updated to meet the realistic needs of women and all patients. The first semi-surprise was that I needed a prescription from my OB/GYN to get a mammogram, even though federal guidelines recommend it. That may seem obvious to some, or at least totally understandable, but the admin involved can be prohibitive.
As a therapist specializing in supporting millennial moms who are often overwhelmed by their mental load, I know many women who will have to make extra phone calls to get a prescription, ensure it is faxed over, and schedule an appointment at the bottom of their never-ending to-do lists. Many friends have said, “I’ll get to it, I’ll get to it,” but barely know where to begin if they do not have an OB/GYN or primary care physician.
The next unexpected minor hiccup was that my consent forms at the radiology office included an acknowledgment that my insurance plan may not cover the mammogram because I was not yet 40. After finally making the calls and getting to the doctor’s office, it felt a bit like a slap in the face that the appointment date I chose based on my busy schedule, an appointment that was prescribed by my doctor and happened to be a few months before my birthday, could potentially not be covered.
Our health insurance system leaves much to be desired, including this issue, especially for women who cannot afford to pay out-of-pocket. I was also surprised to learn that ultrasound scans are not automatically encouraged for women with dense breasts, though my doctor did prescribe it.
Overall, my screening experience, which took place at a radiologist’s office conveniently located in Rye Brook, was fairly pleasant. Yes, my boobs got mushed in the mammogram machine, but the whole thing took about five minutes and was more uncomfortable than painful. The ultrasound scan was also quick, and the nurses and doctor caring for me were all very kind and informative.