Like all women who get a regular mammography to screen for breast cancer, Dr. Robin Hall was relieved when her test results came back normal in January 2021.
The ultrasound of her breasts also came out fine. Hall, a family doctor, always gets that extra exam because she has so much dense breast tissue, which appears as white on a mammogram, the same color a tumor would have. So an ultrasound provides a better view of what’s inside.
With no signs of cancer in those two tests, Hall seemed ready for next year. But that summer, he began to notice that his right breast was getting larger than his left.
“Most women are a bit asymmetrical anyway. But one morning I woke up and it wasn’t subtle anymore and I said, ‘We have a problem,’” Hall, 63, who lives in suburban Fort Worth, Texas, tells TODAY.com.
“I would never have dreamed that a few months before everything was fine and then it changed like this.”
the doctor knew breast swelling was a possible warning signso she had another mammogram and it was still normal.
But Hall could see the change, so she underwent another ultrasound, and that’s when the radiologist finally found the tumor. The diagnosis: a very fast-growing breast cancer that was buried deep in Hall’s dense breast tissue.
Eight months after her normal mammogram and ultrasound, she underwent a double mastectomy in September 2021. Doctors recommended removal of both breasts because her tissue was so dense and because she was at higher risk of cancer in the other breast. The tumor itself turned out to be 1.5 inches across.
“I feel extremely lucky to have caught him when we did, especially with how fast he was growing and how big he had already gotten in that short period of time,” says Hall.
Look for breast changes
She urges women to look in the mirror once a month to check for breast changes.
“That’s super important… You don’t necessarily have to feel a mass, but if you see that one breast is growing more than the other and it wasn’t always like that; or if you see the wrinkles or dimples in the skin; or if one nipple is pulling in and the other isn’t, anything that’s different on one than the other, even if you just had a normal mammogram two or three months ago, you still need to get checked out,” says Hall. .
“Also, request an ultrasound, especially if you have dense breast tissue.”
About half of women age 40 and older have dense breasts, according to the Centers for Disease Control and Prevention. Former TODAY host Katie Couric is one of them, and for that reason, she would routinely undergo a breast ultrasound. revealed this year when she announced that she had breast cancer.
If your insurance doesn’t cover a breast ultrasound, ask the radiology center for the cash-pay price, Hall advises. It is often not that expensive.
Hall has been on the lookout for breast cancer screening for 25 years, ever since she was 38 and felt a mass in her other breast. When she insisted that it be removed, the bulge turned out to be atypical hyperplasiathe step just before cancer.
It meant her risk of breast cancer was four to five times that of a woman without breast abnormalities, according to the American Cancer Society.
Hall has no family history of breast cancer and worries that other people like her are lulled into a false sense of security.
“I can’t tell you how many women in my practice over the years, and I’ve seen tens of thousands of patients in that time period, say, ‘I’m not worried, we don’t have a family history.’ But what people don’t know is 85% of breast cancer is sporadicwhich means that you do not have a family history”, he points out.
“The two biggest risk factors for breast cancer are #1, being a woman, and #2, aging. So as we get older, all women are at higher risk.”
As a doctor listening to her own diagnosis, Hall remembers going into “let’s fix it” mode. Doctors aren’t always the best patients, and it was strange to go from being a doctor ordering treatment to being the person receiving it, she says.
As a patient, Hall was sometimes frustrated by the lack of communication and friendliness in medical care. He remembers recovering in the hospital after his mastectomy when a nurse insisted he get up and walk around to prevent blood clots. Hall was dizzy from her painkillers and said she couldn’t do it.
But the nurse “had the order to get up and walk around and I just wanted to do that task,” says Hall, noting that she ended up sitting on the floor to avoid passing out. “I think sometimes when people are caring for other people for a long time, they get a little burned out and forget there’s a person there…rule number 1: listen to the patient.”
Today, more than a year after surgery and breast reconstruction, Hall says she is doing well. She did not have to undergo chemotherapy or radiation. But there was a health setback last Christmas: She contracted COVID-19, which left her with a mental haze. It all resulted in a difficult year of recovery from surgeries, general anesthesia, and the coronavirus.
Now, she feels more like herself again. The doctor works part-time at the concierge practice she founded, which allows her to travel and write a book.
“If I hadn’t been aware and just had a regular mammogram and then trusted that, I wouldn’t be in the situation I’m in now,” she says.