Still a believer in mammograms at 40

WEST PALM BEACH, Fla. — Way back about 10 years now, when I was just 40, I had a mammogram.

Just a month before, I'd found a lump in my armpit. When the radiologist informed me that that the mammogram was normal, I asked for a sonogram (ultrasound). He commented that there was an enlarged lymph node in my left armpit but didn't feel it was anything to worry about.

A few months later, the same radiologist repeated the sonogram and reassured me nothing had grown larger. Seven months later, I demanded a biopsy. Luckily I had a friend who was a general surgeon and she agreed.The lymph node was full of cancer. We all believed that the mammogram was normal, so I went on to have a CAT scan and then an MRI to "find" the cancer in my tiny breast. All of the imaging suggested a mass under 2 centimeters. Did I mention that the tumor was 7 centimeters, as big as an orange?

Three years after my treatments were over, I took the films and went to California where nobody would know me or the radiologist. A world-famous radiologist put up the film. I did not tell him anything about the films or to whom they belonged.

In less than 10 seconds he said, "There is an invasive cancer right here and some in-situ cancer around it." He looked at me and smiled. "You aren't going to die of that cancer. I am not so sure about the in-situ part around it, because if they didn't get it all, it can be a bad actor."

I felt both anger and relief. I was upset that we'd assumed the mammogram was negative the whole time, but relieved that he was so confident about my future.

As a doctor whose mammogram, read wrong at 40, did not save her life, I still believe in starting mammograms at 40. If my mammogram had been read correctly, it would also have saved my life. Many patients between the ages of 40 and 50 are diagnosed with early-stage breast cancer just because it was found on a routine mammogram.

As for breast self-exams, those same women who tell me they have no idea what they are feeling find their own breast masses "by accident" in the shower. Over time, your fingertips know your breasts and feel abnormalities.

I'll tell you a secret. I never really did self-exams regularly, but that lump definitely got my attention and, ultimately, feeling it saved my life.

Dr. Melanie Bone is a cancer survivor and gynecologist who practices in West Palm Beach.