Angela Bivins was an Atlanta-based teacher and mother of two when she got the news that changed her life forever.
"I'd felt some tenderness near my left underarm," she remembers. "I asked my sister, who does mammograms for a living [a radiology technician], to do a check, and she told me to quickly make an appointment. She thought it was possibly a cyst."
When Bivins had her mammogram, and then a biopsy, her doctor told her she had breast cancer.
"I was devastated," she says. "I didn't feel like I'd done all I was supposed to do. And as a single mother, I didn't want my children to have to consider the possibility of me not being around. But you have to shift gears quickly and fight for your life. Because cancer doesn't consider your race, your financial status, your age, or anything else."
Who Gets It?
As a 44-year-old African-American woman, Bivins wasn’t a typical breast cancer patient. But she wasn't atypical, either. According to the American Cancer Society, white women are slightly more likely to get the disease than black women. But it’s more common in black women under age 45 than in white women. Other non-white women, like Asians, Hispanics, and Native Americans, have a lower risk of getting this type of cancer.
Many people who get the disease have none of the risk factors.
Of those factors, age is the strongest, after gender. That means you have a greater chance of getting breast cancer as you get older. At age 30, your chances of are 1 in 227. By age 70, they’re 1 in 26, according to the National Cancer Institute.
Women are 100 times more likely get the disease than men because they have much higher levels of estrogen and progesterone, which are thought to trigger breast cancer cells.
Here are some other things that affect your chances of getting it:
Genes: About 5% to 10% of breast cancers in America are caused by gene mutations like the BRCA1 and BRCA2 genes. If you have either of these, your risk of getting it in your lifetime is likely between 45% and 65%. Bivins was tested for the BRCA genes because her mother is a cancer survivor. Her results said she didn't have the genes.
Family History: If a close relative has it (such as a mother, sister, or daughter), your chance of getting it doubles. But less than 15% of women who get breast cancer have a family member who has it.
Radiation Therapy: Women who've had this treatment to the chest area before age 30 (for instance, for Hodgkin’s lymphoma) have a higher risk of getting breast cancer later in life.
Menopausal Hormone Therapy (or Hormone Replacement Therapy): Studies show that taking a combination of estrogen and progesterone hormones for more than 5 years after menopause can increase your risk.
Being Overweight: Before menopause, most of your estrogen comes from your ovaries. Afterward, most of it comes from fat tissue. This raises your estrogen levels, and your chances of getting breast cancer.
Many of the same risk factors for women also apply to men: aging, having the BRCA genes, a family history of breast cancer, and radiation exposure. But men are far less likely to get the disease than women, because they have very low levels of "female hormones" in their bodies.
Who Survives?
It's not always clear. Much of it seems to depend on how advanced the cancer is -- or what “stage” it is -- when doctors find it.
Doctors rate each stage from 0 to IV, depending on the size of the tumor, whether it’s spread to other parts of the body, and other things. A stage 0 means the disease hasn’t spread. Stage IV means it has.
Here’s the American Cancer Society’s, 5-year survival rate by stage:
Stage 0-I -- 100%
Stage II -- 93%
Stage III -- 72%
Stage IV -- 22%
Each type of breast cancer "has a different prognosis and a unique responsiveness to specific medical treatments," says Dennis Citrin, PhD, a medical oncologist at Midwestern Regional Medical Center in Illinois. How well you follow your treatment plan also affects your health, he says.
Bivins agrees. "You have to really listen to those physicians so you can have the best chance of survival," she says. "And so, when they told me to do something, I did it. And I think that's why I'm here today."
About 2 months after her diagnosis, she underwent a lumpectomy (a partial removal of a breast), followed by 12 rounds of chemotherapy over 3 months and 33 straight days of radiation. "The chemotherapy really breaks your body down in its effort to kill off the cancer cells. You have to be patient with your body as it rebuilds itself. That was really difficult for me -- losing my hair, the darkening of my fingernails, the foods not tasting like it should, and the fatigue."
In fact, Bivins says, she’s just started to feel like herself again. She credits a strong support system and lots of prayer for getting her through her ordeal. Her older son acted as a "personal taxi service," shuttling her to and from medical appointments. Friends and relatives cooked meals and kept her spirits up. Coworkers made baskets of supplies - she says the crossword puzzles really kept her mind busy during her treatments.
Expert Advice
"Nearly 5,000 women are newly diagnosed with breast cancer every week in the U.S.,” Citrin says. "Despite the astounding number of women diagnosed, early-stage breast cancer is a highly treatable disease from which many patients can confidently expect to be cured."
He gives this advice:
- If you find a lump in your breast, tell your doctor right away. (In a study he recently did, one out of every 10 women who felt a cancerous lump in her breast delayed seeking medical advice for a year.)
- Find out how advanced the cancer is, and what type you have.
- Explore all treatment options. Talk with a surgeon and an oncologist before choosing a plan.
- Complete the recommended treatment program.
Just a year after starting treatment, Bivins is cancer-free. She meets with other patients and survivors to offer support and encouragement. "I've shifted the focus of my life now to how I can help others," she says.
