photo by: Chansi Long

Breast cancer survivor Shannon Wilson.

Shannon Wilson was healthy and active and up to date on all her wellness exams when, at age 54, she discovered a pucker on her left breast. She knew skin abnormalities like creases and puckers could represent early indicators of breast cancer, so she told her doctor.

Wilson’s doctor dismissed the worry as unwarranted. Her mammogram had revealed no anomalies, and thus there was no reason to be worried about cancer. Wilson left her doctor’s office with a slow-growing malignant tumor on her left breast.

“I felt something was wrong, but I trusted my doctor,” Wilson said. “I wanted to know what it was, if it wasn’t cancer. I definitely had my yearly mammogram but it was difficult to detect because it was so low on the breast and the 3D imaging wasn’t being used at the time.”

Three years passed, and Wilson found herself sitting on the exam table for a different reason — but this time her doctor was gone, and the physician’s assistant stood in her place. Wilson showed her the pucker.

“You should get an ultrasound,” the PA said with concern in her voice.

It was the first day of the school semester when Wilson, a former culinary arts and nutrition teacher at Lawrence High School, got the call saying she needed to have a biopsy because the ultrasound had captured a lump positioned just low enough that the mammogram was unable to detect its presence.

Routine mammograms fail to detect about 30% of breast cancers, LMH Health oncologist Dr. Sherri Soule said.

“(Wilson’s cancer) was in a position that it wasn’t found on the mammogram,” Soule said. “But sometimes just the type of tumor or type of cells don’t show up on a mammogram. They’re great tools, but this is why patients should do self-exams.”

Soule said that when doing self-exams, women should look for lesser-known signs like puckering and dimpling, like Wilson had done.

“Puckering and dimpling are not the typical changes people think about, but skin changes are a very important sign,” Soule said. “I see several breast cancers where skin changes are the main changes. Regardless of the mammogram (results), if you have something abnormal on a physical exam, it needs to be followed up on. If a patient isn’t getting the answers they need from their primary care doctor, they can self-refer to the breast center. They need to be persistent.”

Fortunately, Wilson was able to get a breast cancer diagnosis and begin treatment before it metastasized to her lymph nodes. She was originally diagnosed with stage four cancer, but her diagnosis was later reduced to stage three.

Wilson was placed on a daily aromatase inhibitor to halt estrogen production and starve her cancer. She also started chemotherapy and eventually began to lose her hair.

Wilson’s son, Bryce Wilson, who was 25 then, was immediately terrified when his mother told him she had cancer.

“I didn’t have any conceptual knowledge of cancer, and I thought this could take my mom from me,” Bryce said. “I put things on hold. I just stuck around Lawrence because I didn’t want to leave her. I didn’t want to go anywhere. She didn’t agree with that, but you never know which direction it’s going to take. Maybe the treatments are working and they stop working. I just wanted to be around my mom.”

Wilson’s three children, who were in their 20s and 30s, began attending chemotherapy appointments, taking their mother wig shopping and helping her shave her head. One of Wilson’s daughters is a licensed cosmetologist, and when Wilson’s hair began to fall out in spotty chunks, both daughters came over to shave her head.

“My sister called and said, ‘Mom’s ready to have her hair shaved off. Can you come with me? I can’t do this by myself,'” Natalie Riggs said. “I said, ‘absolutely.’ And we went to my mom’s house where she had a few of her other friends, and we were all having fun with the situation. We buzzed that hair off and made it a celebration.”

Riggs was struck by how visible and prominent her mother’s facial features suddenly became.

“It made me realize when you don’t have hair as a distraction, you can really see a person’s features, their eyes, lips, and nose, and I remember thinking my mom looks really good,” she said. “It was really interesting to see how beautiful she is when you can see her true facial features.”

After months of chemotherapy — during which Wilson kept teaching — she had a single mastectomy and breast reconstruction. Then she took a daily estrogen blocker for at least a decade.

“It’s recommended you stay on an estrogen blocker for at least five years or 10. I took it for 10 years, then I chose to get off it because I was still feeling the side effects,” Wilson said.

The fact that Wilson has had breast cancer has health implications for her daughters and granddaughters.

“One of the things I remember distinctly is how this is going to affect the generations of women in our family,” Riggs said. “I have an older sister and she has two daughters; there’s me and I have two daughters. That was something lingering on my mind.”

Riggs said her doctor tells her she needn’t be too concerned about a genetic link at this point because her mother is the only woman in her family who has received a breast cancer diagnosis. Riggs will be getting her first mammogram when she turns 40 in a few months, but if she notices something abnormal during her self-exams that the mammogram doesn’t detect, she will be more apt to follow up.

“One of my main takeaways with this whole experience is you know your body and if a doctor is telling you something that doesn’t sit with that, it’s OK to get a second opinion,” Riggs said.

Wilson’s cancer has not returned, and she’s thankful that the tumor was so slow-growing that the late diagnosis wasn’t fatal.

“Other than the diagnosis being delayed, I was pretty textbook: my cancer responded to treatment really well,” Wilson said. “I do worry sometimes that it’s going to come back, but I feel like I’m on the other side of it now. Hopefully it’s over.”