At the beginning of the pandemic, I was baking bread, worrying about my unemployment, and my largest health concern was getting my dog’s teeth cleaned. As a 37 year-old with no history of cancer in my immediate family, the thought that the lump on my left boob could be breast cancer didn’t even cross my mind. Thankfully, I caught it early.

Right after my diagnosis, I was also thrown into a mix of an amazing support group called the Bay Area Young Survivors, a group of people who have breast cancer between the ages of 20 and 45. It’s been reassuring to learn that so many people go through this and proceed with their lives; yet at the same time, I’m stunned and saddened to see how common this is, and how uneducated I was about it. I had no idea that within the U.S., 1 out of 8 women will get invasive breast cancer over the course of her lifetime, and 1 out of 25 of women will get it before she turns 40! (according to breastcancer.org and cancer.org)

So how did I find the lump and decide to look into it, when I was completely clueless about all this? I wish I could say I found it while responsibly doing a self-exam. Or that it was the OBGYN annual visit in February, who does a yearly breast exam. No, it was my partner who was playing with my boobs. (We don’t tell our parents about that part.) My partner, as a frequent fondler of my boobs, knew instantly the lump wasn’t there before and insisted on my getting it checked out. Since I just had a breast exam with my OBGYN only 3 months prior, I was confident it was nothing.

At this point of the story, I think about how much I relied on my OBGYN’s result to give me false confidence. I didn’t know that breast exams are not a sure-fire thing. Younger people tend to have dense breast tissue, so any lumps are hard to detect. I also didn’t know that cancer cells can grow fast, and a tumor can suddenly get hard overnight. I think about how lucky I was to have happened to be with my partner at this time in my life. Without his detection, it would have been another 3 years before I got my first mammogram, when I turn 40. Without his insistence to get it checked out, I would have waited until the pandemic was over to pay a visit to the doctor. I wasn’t familiar enough with my boobs for the lump to have stuck out as suspicious, the way it was for him.

My dentist always reminds me to floss. Every time I get my teeth checked, she gives me a refresher on how flossing keeps plaque and gingivitis away. She even demonstrates how I can floss better. It’s so simple: flossing thoroughly every day results in no root canal in the future. Why don’t we get similar reminders about the importance of early detection from our OBGYNs? Doing a self-exam every month results in earlier detection. Why haven’t I ever gotten a demo on how to do a self-exam?

Dear Reader,

Let me be like my dentist to you, but instead of for oral care, for boob care. An early detection of stage 0 breast cancer is easily treatable, and stage 4 is bad news. Stage 4 is essentially terminal with no cure, only treatment to delay the spread of cancer. Early detection is so important, and it can be easy to do.

Don’t wait for a doctor or partner to examine your boobs. Do a breast exam on yourself once a month. They aren’t reserved for just OBGYNs, it can be done yourself. For those who do annual mammograms, you should do this too, since mammograms are only once a year.

Some tips!

• You can do it while you’re in the shower, bath, in front of the mirror, or in bed.
• What are you looking for? A little lump, something hard in the midst of soft boob tissue, anything unusual. Over time, you’ll know your boobs well enough that if something is unusual, it’ll stand out.
• Lying down is better to do a self-exam, especially for those in their 20s and 30s who have dense breast tissue, since gravity will help it flatten them down
• In addition to checking both boobs, check the area around it too, like the armpits, collarbone and your chest plate. Cancer can show signs in these areas too. Might as well since you’re there already!
• How frequently? Once a month is good!

More accurate ways to get them checked out

• A mammogram, which is a special X-ray just for boobs. It squishes your boobs into a flat pancake and takes 2D X-ray pictures from the sides and top and bottom. Mammograms are administered every year once you turn 40, and are covered by health insurance. If you are 40+, make sure you do this EVERY year. Do not skip a year.
• A 3D mammogram, which is similar to a 2D mammogram, except that there will be multiple images from many different angles. They will then compile these images to create one 3D image. 3D mammograms are great for younger people with dense breast tissue, and can catch breast cancer earlier than a regular 2D mammogram. These aren’t widely available like regular mammograms are. Ask your doctor if a 3D mammogram is available to you.

And there’s another less common way that’s very effective:

• A breast MRI: A fancy electromagnetic imaging scan where you lie down inside a giant tube for about 45 minutes. This is more reliable than a mammogram, and is typically reserved for people who are high-risk, such as those having a mom or sister with breast cancer, or a high risk gene mutation.

Things to note:

• Not all lumps are cancerous. There are a lot of benign (noncancerous) lumps. If you feel a lump, talk to your doctor and get a mammogram.
• People in their 20s and 30s tend to have dense tissue, and lumps can be harder to feel. The exams with hands are not 100% fool-proof.
• Those in your 20s and 30s especially have to be your own advocates. If you think something isn’t right, push for more imaging and tests.
• A mammogram is the better way to detect cancer than a breast exam with hands. Unfortunately, health insurance companies only cover the cost of a mammogram for people 40+, BUT you can opt-in for one and pay for it out-of-pocket. It would cost a few hundred bucks. Some doctors might require a reason for you to even pay for a mammogram, like having some family history in breast or ovarian cancer. If you have the means and want to opt-in for one, but your doctor won’t let you, push harder on him/her, or look for another doctor who will honor that request.
• While a mammogram is likely to get a more accurate picture than a breast exam done with hands, this is also not 100% fool-proof because, again, those in their 20s and 30s have dense breast tissue. A 3D mammogram or breast MRI would get a better scan than a mammogram, but these are typically reserved for those who are high-risk, such as having a family history of breast cancer, or those with high risk gene mutations. Ask your doctor about these options.
• Has your mom, sister, aunt, or grandmother had breast cancer? You might be high-risk. Bring it up with your doctor and ask for mammograms and/or breast MRIs every year. Don’t rely on just the breast exams during annual check-ups with the OBGYN, and don’t wait until you’re 40 for your first mammogram.

Early detection saves lives!

Taking care of other areas of your bod like hair and teeth might come second nature to you. Let checking your boobs become second nature too, it might save your life!

Some links

Here are a couple of my fav comics who talk about their breast cancer experiences:

• Tig Notaro, Live, a stand-up comedy set about her breast cancer
• Wanda Sykes and her elective breast reduction surgery that revealed her cancer, which led to her double mastecomy

And some resources:

• National Breast Cancer Foundation
• Susan G Komen
• Breastcancer.org