October is Breast Cancer Awareness Month. The following true story was sent to me by a woman who wishes to impress on other women the extreme importance of routine breast exams and mammograms. This is what recently happened to her.

As Carol (fictitious name to protect privacy) left the office, she hollered to her coworkers, "I'm going across the hall for my yearly mammogram. Anyone want to go in my place?"

No one volunteered. The test itself hurts; it pinches and is annoying, but annual mammograms are strongly recommended for women over 40 years of age, whether there is a prior family history of breast cancer or not. Carol reluctantly left for her scheduled appointment.

There was no incidence of breast cancer in Carol's family. The youngest of four children, she has two older sisters and an older brother. Her mother died at age 77 from complications of heart surgery. Her father died of melanoma at age 58. Both parents had regarded doctors as people to see only when you were really sick.

The date of Carol's appointment was September 23, 1998. The technician, a chatty woman about Carol's age (54), went about the business of placing, squeezing, photographing and apologizing for any discomfort she might be causing. Carol assured her that it was all right and grit her teeth until it was over. She was ushered to the waiting room and asked to remain there until the technician was sure the films were acceptable to the radiologist.

Suddenly she was back, saying that she needed another view. This had happened once before, so Carol was not alarmed. A second set of films were taken and she was again ushered to the waiting room only to be called back a third time. After the third set was taken, the technician asked her to come in and speak with the radiologist. Carol knew this was not your ordinary 'normal' mammogram.

The radiologist showed her the films taken that day and each of the two previous years. "Unfortunately," she said, "There have been changes. You are looking at cancer."

Floored, Carol said to her, "You mean I am looking at a lump in my breast. What makes you think it's cancer?"

Carol couldn't remember what she said next. Her heart was pounding and she felt light-headed. She just wanted to get out of there! She returned to work and entered her manager's office, shutting the door behind her. She was in tears as she described the experience. One of her coworkers had had breast cancer 7 years before. Carol asked to see her and poured her heart out to her. As a breast cancer survivor, the woman comforted Carol, reassured her and saw to it that she was seen by a surgeon within 24 hours.

The surgeon reviewed the mammography report and recommended a bilateral breast biopsy. The cancer was in the right side, and the left side showed calcification, which can indicate a precancerous condition. Arrangements were made for the next day, September 25th. Carol was told that the lump, which was about the size of a pencil eraser, might be removed, a procedure called a lumpectomy. Microscopic examination would be done immediately, and a frozen section would be sent out for biopsy. Carol was to report back to the surgeon on September 30 for the results.

The news from the surgeon was encouraging. Although the lump was malignant, the surrounding tissue was unaffected. It was recommended that Carol proceed to the care of an oncologist and also have the lymph nodes removed from under her right arm. Most likely, a short term course of radiation therapy will follow and possible additional therapy. Her long term prognosis is very good. Breast cancer caught at this stage and treated right away, Carol told me, results in a 90 to 95 percent survival rate after five years.

It still amazes Carol that she could look and feel so well and yet be harboring cancer. The tumor was so small, it could not be felt, not even by a doctor. If Carol had avoided the dreaded annual mammogram, the tumor would have continued to grow to a more advanced stage, requiring more radical surgery and treatment. She shudders to think about how much her chances of survival would have diminished.

One week after her mammogram, Carol's tumor had been removed, her treatment planned and a good prognosis given. She's looking at life a bit differently now and has new respect for mammography. As far as breast cancer is concerned, it can develop but cannot hide from a mammogram.

"Please, please, ladies," Carol says, "Be good to yourselves. Take 20 minutes to get a mammogram each year. Yes, it pinches, but the alternative is ... well, you know."

Author's Note: Thank you so much, Carol, for this timely and critically important message to all women.