Copyright thenassauguardian
Eleven-years into remission, Sian Bevans, is sharing her story in hopes that it encourages others to stay vigilant, trust their instincts, and never delay follow-ups. “Early detection truly saves lives,” said Bevans. Bevans said she has always had fibrocystic breasts – a common noncancerous condition that causes painful lumpy breast tissue, changes to the breasts that are usually harmless and don’t require treatment. But she made a habit to pay attention to any changes, especially if a lump felt different. In July 2012, Bevans noticed a lump in her left breast and mentioned it to the radiologist before her mammogram during a visit to Cleveland Clinic Weston Hospital, South Florida. She also took an ultrasound and needle biopsy, and a marker was placed on the lump to confirm it had been previously examined and was fibrocystic. Bevans was told by the radiologist that there were some calcifications seen on her mammogram in her right breast and recommended a follow-up to monitor them. “At that time, I had never heard of calcifications and did not pay much attention to the report,” said Bevans. Breast calcifications are calcium deposits that develop in breast tissue. They’re common and often show up on a routine mammogram. While they’re usually benign (noncancerous), breast calcifications can be a sign that a person is at risk for developing breast cancer. “Cleveland Clinic later sent me letters reminding me to follow up about the calcifications, but I had just started a new and exciting job that took all my focus, so I put it off.” It was in November 2013, while making a presentation to Sister Sister Breast Cancer Support Group, that Bevans said she decided to ask about calcifications, and learned they could be something serious and that she needed to follow up right away. “In January 2014, I made an appointment with breast surgical oncologist, Dr. Margaret Thompson, for the follow-up. She was so warm and easy to talk to, that even when she expressed real concern, I still felt calm and reassured,” said Bevans. “I explained that I was experiencing numbness in my right arm and hand. I wasn’t sure if it was related to the amount of typing and writing I did at work, but I thought she should be aware.” Thompson had Bevans do another mammogram, ultrasound and biopsy of her right breast and underarm. They found cancer in her right breast and lymph nodes. She said the doctor put together a plan of action and brought in hematology oncologist, Dr. Thomas Samuel onto her care team. “Both doctors were very direct in explaining that the cancer was aggressive and called for a comprehensive treatment plan.” Bevans said it was recommended she undergo a bilateral mastectomy, followed by four cycles of Adriamycin and Cytoxan every other week for four weeks; Taxol and Herceptin every week for 12 weeks, then every three weeks for one year; radiation therapy five days a week for six weeks; a radical hysterectomy, since she was premenopausal; and 10 years of Letrozole maintenance medication. “At first, it all felt like so much to take in, but I followed their recommendations to the letter.” Bevans said through it all, her faith in God, the love and support of her family and friends, and the team at Cleveland Clinic Weston Hospital gave her the strength she needed to get through each stage. “Every follow-up visit, whether every three or six months, was truly a pleasure. I was always treated with kindness, compassion, and respect. I can honestly say I could not have asked for a better team to walk with me through this journey.” More than a decade later, Bevans said she is grateful for life, faith, and for the people who stood beside her. “My journey has taught me the importance of listening to your body and never ignoring a reminder to follow up.” She encourages others facing similar diagnosis to lean on their faith, loved ones and their care team. And to take each step one day at a time, hold on to hope, and trust that they can make it through. “Healing is not just physical,” said Bevans. “It is also emotional and spiritual.” She said people, facing a cancer diagnosis, must stay positive. “I am forever thankful to God for carrying me through every step of this journey. My heartfelt gratitude goes to my amazing family, friends, church community and work colleagues for their unwavering love and support. I am also deeply grateful to the Cleveland Clinic team for their compassion, expertise and exceptional care. Their dedication made all the difference, and I will always be thankful for the hope and healing they provided,” said Bevans. During October, Breast Cancer Awareness Month is observed, and awareness of the disease is heightened. People are encouraged to be aware of their breasts – what they feel and look like, and to do self-examinations. Women and men are encouraged to recognize the symptoms that may indicate breast cancer and to be cognizant of the fact that different people have different symptoms of breast cancer. And that some people do not have any signs or symptoms at all. Symptoms people need to be aware of include a new lump in the breast or underarm (armpit); thickening or swelling of part of the breast; irritation or dimpling of breast skin; redness or flaky skin in the nipple area or the breast; pulling in of the nipple or pain in the nipple area; nipple discharge other than breast milk, including blood; any change in the size or the shape of the breast; and pain in any area of the breast. People are also reminded that no breast is typical, and what is normal for one person may not be normal for another person. The way a woman’s breasts look and feel can be affected by getting their period, having children, losing or gaining weight, and taking certain medications. Breasts, they say, also tend to change with age. There are different types of breast cancer. The most common types are invasive ductal carcinoma, and invasive lobular carcinoma, according to the CDC. In ductal, the cancer cells begin in the ducts, then grow outside the ducts into other parts of the breast tissue. Invasive cancer cells can also spread (metastasize) to other parts of the body. In invasive, cancer cells begin in the lobules (a gland that makes milk), then spread from the lobules to the breast tissues that are close by. The invasive cancer cells can also spread to the other parts of the body. The type of breast cancer depends on which cells in the breast turn into cancer. Risk factors a person cannot change include getting older – the risk for breast cancer increases with age; most breast cancers are diagnosed after age 50; genetic mutations – inherited changes (mutations) to certain genes, such as BRCA1 and BRCA2. Women who have inherited these genetic changes are at higher risk of breast and ovarian cancer. Reproductive history – early menstrual periods before age 12 and starting menopause after age 55 – exposes women to hormones longer, raising their risk of getting breast cancer; having dense breasts – dense breasts have more connective tissue than fatty tissue, which can sometimes make it hard to see tumors on a mammogram. And women with dense breasts are more likely to get breast cancer. Personal history of breast cancer or certain noncancerous breast diseases; family history of breast or ovarian cancer; and previous treatment using radiation therapy. Risk factors you can change include not being physically active – women who are not physically active have a higher risk of getting breast cancer; being overweight or obese after menopause – older women who are overweight or obese have a higher risk of getting breast cancer than those at a normal weight; taking hormones – some forms of hormone replacement therapy (those that include both estrogen and progesterone) taken during menopause can raise risk for breast cancer when taken for more than five years. Certain oral contraceptives (birth control pills) also have been found to raise breast cancer risk. Reproductive history – having the first pregnancy after age 30, not breastfeeding, and never having a full-term pregnancy – can raise breast cancer risk; and drinking alcohol – studies show that a woman’s risk for breast cancer increases with the more alcohol she drinks. According to the CDC, research suggests that other factors such as smoking, being exposed to chemicals that can cause cancer, and changes in other hormones, due to night shift working, also may increase breast cancer risk. People who are high risk for breast cancer include those with a strong family history of breast cancer or inherited changes in their BRCA1 and BRCA2 genes. They may also have a high risk for ovarian cancer. Women are especially also encouraged to have themselves screened for breast cancer before there are signs or symptoms of the disease. Although breast cancer screening cannot prevent breast cancer, it can help find breast cancer early, when it is easier to treat. Women are encouraged to talk to their doctor about which breast cancer screening tests – mammogram, breast magnetic resonance imaging (MRI) – are right for them, and when they should have them. Other breast exams include a clinical breast exam by a doctor or nurse, who uses their hands to feel for lumps or other changes; and each individual being self-aware of how their breasts look and feel, so they can notice symptoms such as lumps, pain, or changes in size that may be of concern.
