Breast Cancer and Daughters

Only in a family like mine, where breast cancer comes up fairly often in discussion, would my daughter Kirtley call me into the bathroom to see a pimple on her breast at age 14.

"Mom, it’s not breast cancer is it."

It makes me crazy that she has to live like this, but long ago I stopped feeling guilty about it.

I have been asked what I tell my daughter, and I can recall with clarity what she was told and when.

At 2 when she first asked about my breast, I told her I had a booboo. I had not been reconstructed yet and had a scar and flat side where my right breast used to be. She kissed it. I prayed I would live to raise her.

At 6, when her grandmother died of breast cancer, she didn't really connect my cancer with my mother's. But my mother's diagnosis brought up an entirely new fear that my cancer was hereditary and Kirtley was at 50 percent risk if I was positive. She could not be tested until she was 18, so it was premature to talk about it. My prayer life changed to include a request that she not get cancer.

When she was 9 she asked me for the first time and out of the blue if she would get breast cancer. Unprepared, I just said "no" before leaving the room to cry.

At 10, she asked again. And I had an answer. But before I could get it out, she said, “But before I am old enough, they’ll have a cure, right.” Right I told her.

At 14, she asks if the pimple on her breast is cancer. “No,” I assure her calmly, “it isn’t.” But it’s good to always check.

When she was 17, she was diagnosed with polycystic ovarian syndrome (PCOS), which plays havoc with her hormones. According to one long-term study on PCOS, women with PCOS are not at an increased risk for breast cancer, but there are other links that impact the possibility. Obesity, diabetes, hormonal irregularity and infertility are some known risk factors to developing breast cancer — and PCOS may cause these risk factors to develop. In the same study, a positive association between PCOS and the presence of family history of breast cancer was found.

This was not something I wanted to deal with, and she was approaching the age when I could make recommendations about what she consider doing, but I could no longer take her to the doctor.

I sent her books on diet and exercise while she was in college, and she read them and paid attention. She knows we don’t have the gene, despite me being diagnosed at age 36. She asked me about it when she went to her first gyno appointment that came with her first job. She called and asked me if I had been tested. "Yes," I told her. "So when were you going to tell me," she said. "Never," I said. "I am negative."

So it ultimately looks like she is in the same bucket as most women in the U.S. when we look at her risk. One in eight during her lifetime.

She is now 31 and has had two mammograms, both of which were normal. Her awareness of breast cancer increased during the year she worked at Susan G. Komen for the Cure, She has undergone testing associated with PCOS and is working on her weight.

All families have their issues. I have friends who struggle with bipolar depression. I have friends who struggle with mental illness or muscular problems. I have friends whose children have learning differences. Our family has cancer. Do I wish we didn’t have to talk about it? Sure.

I do know one thing. I may not be able to keep Kirtley from getting breast cancer, but she won’t die of ignorance because I didn’t want to upset her by talking about it.