Taylorville woman says chance discovery of cancerous lump stresses the importance of self-examination

Taylorville -- Shock...fear...disbelief...sadness. These are all words used by 32-year-old Emily
Todino to describe her initial reaction to being diagnosed earlier this summer with breast cancer. "We were really scared at first," says Todino, settling into a favorite chair in the living room of her Taylorville home and seeking out the reassuring eyes of her husband, Paul, seated close by. "You start to ask yourself questions like, 'Am I going to be around to see my kids grow up?" But now, as she prepares for her second round of intensive chemotherapy, this courageous young woman says that initial shock of her diagnosis has worn off. And she is seizing every opportunity to speak out, urging men and women of all ages to heed the advice of the American Cancer Society, specifically that aimed at early detection and self-examination."If you find a lump," she says, "and you don't remember it being there, by all means get it checked out."

On Monday, July 27, 1998, Emily had a cyst measuring about four centimeters in diameter surgically removed from an area several inches above her right breast. "I found it purely by accident," she admits. "For some reason, I ran my fingers across that area of my chest one day and thought, 'Hmm, I don't remember that lump being there.'" At that point, she says, cancer was not a serious consideration. "I don't fit the typical profile of someone at risk for breast cancer," says Emily. "I'm 32 years old. I have no family history of any kind of cancer. I don't smoke. I exercise on a regular basis. We eat healthy foods."  
The following Monday, however, Emily and Paul received news that would forever changes their lives in a most dramatic and irreversible way. A cancerous tumor measuring less than one centimeter in diameter had been discovered inside the cyst removed a week earlier. "We were totally shocked," says Emily. "The doctors were shocked. When they removed the cyst, they had assured us that, considering my background and family history, they felt there was nothing to worry about." Statistics show only about 1.5 percent of all breast cancer cases diagnosed involve women in Emily's age bracket. Because her tumor measured less than two centimeters (about 3/4 inches) in diameter and had not spread beyond the breast, Emily's cancer was said to be in Stage 1 of its development.
Breast cancer can range from Stage 0 all the way to Stage 4, in which the disease, regardless of its size, has metastasized to distant organs such as bones, lungs or lymph nodes not near the breast."We had three options," says Paul. "Either a lumpectomy, also referred to as 'breast conservation,' in which none of the breast is removed, a total mastectomy, involving removal of the entire breast, or a mastectomy with reconstructive surgery. We chose the lumpectomy because, in this case, the prognosis was the same for all three."
Since her diagnosis, Emily has set out on a relentless quest for information regarding her disease. And in her search, which has included countless questions of her "army" of physicians, she soon found a ray of light at the end of the tunnel, which she says gives her the courage to face what lies ahead, including three more rounds of chemotherapy and six to either weeks of radiation. That ray of light comes in the form of steadily declining mortality rates for women with breast cancer.
Of the estimated 180,000 women in the United States expected to be newly-diagnosed with breast cancer this year, 97 percent of those with "localized" cancer, like Emily's, are expected to survive an additional five years (in the 1940s, only 72 percent of those patients would have been expected to survive). Sixty percent of women diagnosed with breast cancer survive 10 years, and 56 percent survive 15 years. "It's just like the say in the advertisements," says Emily. "Early detection is critical. And the key to early detection is self-examination. I probably wouldn't have gotten a mammogram for eight more years, when I turned 40. By then it would have spread. We have to remember that cancer doesn't discriminate. It can strike anyone, at any age." In fact, recent guidelines from the American Cancer Society suggest women 20 years of age and older should perform breast self-examination every month. Women 20-39 are urged to have a physical breast examination performed by a health care professional, such as a physician, physician assistant, nurse or nurse practitioner, every three years. Women 40 and older are encouraged to have a physical breast examination performed by a health care professional every year. And women over 40 and older are urged to have a mammogram every year.
As a result of her chemotherapy, Emily, like other cancer patients, must deal with a repressed immune system, as the powerful, cancer fighting drugs also kill off most of her white blood cells. In such a state, she is highly susceptible to infections and must be rushed to the hospital at the first sign of a fever. But these and other "inconveniences," say Emily and Paul, have been made much easier by a strong support group of caring friends and family. "Without them," says Paul, "this whole ordeal would be a lot more difficult." As far as side-effects from her treatment, Emily says she has yet to experience much beyond an occasional migraine headache. Much of the nausea which so often accompanies chemotherapy has thus far been kept under control by medications taken prior to each session. "One of the hardest things to deal with right now is being tired all the time," Emily says. "I went to watch my kids (Jake, age 8, and Drew, age 6) play soccer the other day and came home totally exhausted. And work is hard. I can't to the things I'm used to being able to do."  
As for the unavoidable hair loss that will come as a result of the chemotherapy, Emily says she is fully prepared and has a very positive outlook. "It'll grow back," she says, effortlessly pulling a small clump from her as yet still full head of hair.  "I look at it this way," she says, with a slight shrug of her shoulders as a hint of a smile spreads across her face. "I won't have to shave my legs for the next six months." At this point, following two surgeries and one round of chemotherapy, Emily says the doctors believe there are "no live cancer cells" remaining in her body. "We'll get through this," she says. "Sometimes life throws you a curve, and you just have to do what you have to do. But we will get through it." October is "National Breast Cancer Awareness Month," with the third Friday of the month, October 16th, designated as "National Mammography Day." Article originally published

Article originally published Sunday, Sunday, October 18, 1998
in the Taylorville Breeze-Courier, Taylorville, Illinois
Reprinted with kind permission