As a GP, Annie Si is well aware of the statistic: one in nine New Zealand women will get breast cancer.
But it wasn’t until 2021 that the reality hit home, when close friend and colleague Heidi MacRae, with whom she founded her North Shore practice, was diagnosed with triple negative breast cancer.
“It’s very close to home when it’s someone close to you,” Si tells the Herald.
Her friend’s diagnosis made her more vigilant about her own breast health. Shortly before MacRae’s death in November 2022, Si says, “I noticed a different sensation or different pain on my right breast and reached out to get an earlier scan.”
Si was 49 at the time and eligible for funded mammograms every two years – however, it had been just 10 months since her last scan.
“It was discovered that I had a papilloma, which is a pre-cancerous lesion.”
Si had a lumpectomy to remove the papilloma. Just five months later, she noticed a similar pain in her left breast.
“I was almost trying to ignore it because ... surely nothing can be wrong.”
But she couldn’t shake the “niggling thought” that something wasn’t right.
She had another ultrasound and mammogram – then doctors noticed something on the left breast they hadn’t seen five months before.
“When they biopsied it, they said it was cancer cells. I wasn’t expecting that.”
Si feels “very lucky” that her diagnosis was grade zero DCIS – ductal carcinoma in situ, a very early and non-invasive form of the disease.
She chose to have a double mastectomy with a sentinel node biopsy, which meant she wouldn’t need radiation or chemotherapy.
The decision to remove both breasts was “very difficult mentally”, she says. But as someone with dense breast tissue, a known risk factor for breast cancer, it was a no-brainer.
“I needed to have peace of mind. Once you’ve had breast cancer, the fear of screening the other breast or the remaining tissues is sometimes difficult.
“It’s a very personal decision, but I think it should be an option for women to have a think about, whether or not they want to remove everything or have symmetry.”
Si notes that if she’d waited until her yearly screening was due, the outcome may have been different.
“Even though regular screening is great and obviously mammograms help detect early cancers, they don’t stop cancers from happening,” she says.
In between mammograms, if women feel something is different in terms of their own breasts – skin or nipple changes, for example – they should get examined or get an opinion from a health professional as to whether they should have an earlier screening, Si says.
“We’re very busy and often we don’t think about symptoms or checking our breasts.
“Maybe if I didn’t experience that personal tragedy of losing Heidi, I may not have even taken note and taken action as quickly as I have.”
Si adds it’s essential for women to do regular self-checks and know that the first sign of breast cancer isn’t always a lump.
“In my line of work, I have had women who come in and go, ‘There’s this very different sensation, something’s not right’ as the first presenting complaint.”
According to the Breast Cancer Foundation, 85% of Kiwis diagnosed with breast cancer will survive 10 years or longer – 95% if their cancer is detected early on a mammogram.
In New Zealand, mammograms are funded every two years for women from the ages of 45 to 69, with plans under way to raise the upper age limit to 74.
“If you’re eligible, then please get the screening done. And don’t delay,” Si says.
“For some women, yearly is even better, but two-yearly is the screening programme that we’ve got now. So don’t make it two-and-a-half or three, because some people put it off for more than two years.”
It’s taken her a couple of years to feel ready to share her own experience – but she knows it’s important to talk about it.
“If it helps save one person or gets the message out to more people to do screening or be aware of those things, then it’s definitely worth it.”
The memory of her friend has empowered her to speak out about her own diagnosis.
“She was amazing ... I think she definitely would have asked me to just go for it and put myself out there. So I was like, ‘I can do it’.
Bethany Reitsma is a lifestyle writer who has been with the NZ Herald since 2019. She specialises in all things health and wellbeing and is passionate about telling Kiwis’ real-life stories.