Breast cancer survivor Jennifer Mukai, 43, lives in the Seattle area. Mukai got her first-ever mammogram in May 2009, right after turning 43. That mammogram led to her breast cancer diagnosis.
Mammograms don't determine whether someone has breast cancer. But they can show a suspicious spot that warrants further testing.
Mukai says her first mammogram showed some suspicious spots in her right breast. She quickly got a follow-up mammogram and an ultrasound to take another look, and then a biopsy. While she was getting those tests and waiting for the results, she did some research and learned that it was unlikely but possible that she had cancer. "I prepared for the worst-case scenario," Mukai says.
She was diagnosed with a tumor in her right breast. She had considered herself to be in good health, with no chronic illnesses. And breast cancer is usually found in older women. So before her diagnosis, breast cancer wasn't on her radar. "That didn't cross my mind," Mukai says.
The tumor was tiny, she says, and the doctors she talked with said she could have a lumpectomy (removing the tumor and saving the rest of her breast) followed by radiation. Mastectomy (surgery to remove the breast) was an option, but it wasn't a necessity.
The diagnosis was still "a bit of a shock," she says. And she counts herself as "very lucky" to have found it. "Even though it's not good news, it's not a death sentence that it would have been years ago," she says.
Aggressive approach: Mukai did her homework, talking with her doctors and weighing the pros and cons of each surgical option.
"It's life-altering, or body-altering, decisions that you have to make, and getting yourself educated helps you initiate conversations with your doctor that you can understand and make the right one, so you feel much better about making those decisions," says Mukai.
"I decided on bilateral mastectomy," she says. That's surgery to remove both breasts -- the one with the tumor and the other one, which showed no signs of cancer.
Mukai wasn't keen on the idea of getting radiation therapy, and she also wanted to minimize her risk of recurrence.
"For me, it was a matter of survival," Mukai says. "I really didn't want to go through this again, given that I have, perhaps, 40-plus years to live. ... My breasts are a part of me, but they don't define who I am. So I really had no issues taking them away."
Genetic testing showed no BRCA gene mutations tied to breast cancer or ovarian cancer.
But with a family history of pancreatic cancer, Mukai thought that she might have genetic risk factors that haven't been discovered yet. "I'm in prevention mode," she says.
Mukai is of Japanese ancestry. Breast cancer is rarer in Asian women than in white or African-American women. But breast cancer cases are rising for Asian-American women. That may be because they're adapting to Western diets and lifestyles, but that's not certain.
Building her team: Mukai met with doctors from two different facilities before deciding to get treated at the Seattle Cancer Care Alliance.
Mukai liked the fact that her doctors all worked together in the same place, and she encourages other breast cancer patients to "take the time to get a really good team of doctors you feel comfortable with. For me, that was important, that I had a group of people that gave me the confidence to make those decisions."
Her team included a nutritionist whose advice helped Mukai regain a sense of control.
"What I have found with the diagnosis is you have a sense of loss of control of your body. I thought that I was healthy, I thought that I ate the right things, I rarely get sick, so to have a diagnosis of cancer is kind of like something let you down. Seeing a nutritionist put that control back in my lap a bit -- getting an understanding of what foods I should eat, how much of it, exercise, those were the more tangible things that I could do during this process that could give me a sense of control," Mukai says.
Talking with other women who've been through breast cancer also helped. "It's kind of a quiet but very large sisterhood out there of cancer survivors that came out of the woodwork whom I've talked to," she says. "Those people have been tremendous in giving me the support. I'm very grateful for that."
After mastectomy: Mukai got her mastectomy at the end of July 2009. During that surgery, doctors inserted expanders in preparation for implants that would reconstruct her breasts.
Seeing herself for the first time after her mastectomy, "I was more amazed at what they could do surgically, and the advancement in medicine," Mukai says. "It's not the radical mastectomy of our grandmothers' generation or even our mothers' generation. They can put you back together pretty well. So I was more fascinated. ... It didn't look pretty, but it's part of a process."
Joining a clinical trial: Mukai decided to enroll in a clinical trial that would test a breast cancer drug that's usually given to postmenopausal women, in younger women such as herself.
"Anything I can do to help advance the care or cure of cancer would be something I'm interested in," says Mukai, who will take the test drug for five years.
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