“It was like time froze,” she said. “I knew that it wasn’t right.”
Today, Krengel, 59, is a breast cancer survivor. She credits her periodic Breast Self Exams for detecting her cancer.
“It’s important to do self exams. I had gotten mammograms nearly every year and it didn’t showed anything,” she said. “You have to be vigilant.” Krengel discovered her lump 14 months after her last mammogram.
Dr. Kristin Corgan specializes in breast surgery at WellStar Cobb and Kennestone hospitals. She said women should perform self-checks once a month, beginning at age 18, preferably at the end of their menstrual cycles when breasts are least influenced by hormones (least “lumpy bumpy”). She said 20 percent of cancers are found by BSE.
According to the American Cancer Society, women should lie flat on their backs for a BSE, placing their right arm behind the head. Using the finger pads of the three middle fingers on the left hand, make overlapping dime-sized circular motions to feel breast tissue.
Three different levels of pressure are needed to feel the breast tissue. Light pressure is for tissue closest to the skin, medium is to feel a little deeper, and firm is to feel issue closest to the chest and ribs. A firm ridge in the lower curve of each breast is normal, but the ACS advises talking to a doctor if something different is felt there.
Move the breast in a up and down patter starting at an imaginary line straight down from the side of the underarm and moving across to the breast to the middle of the chest bone. Women are advised to check the entire breast going down until they feel only ribs and up to the neck or collarbone. Repeat the exam on the left breast.
The ACS also encourages women to stand in front of a mirror with hands pressing firmly down on the hips and look for any changes in breast size, shape, contour, dimpling, redness or scaliness of the nipple or breast skin. Examine each underarm while sitting up or standing with the arm slight raised.
Dr. Corgan said, “The main thing is for a woman to be thorough, cover her whole breast and be consistent in doing BSE and in the timing of performing BSE. Over time, a woman will get to know her breasts very well and will be equipped to notice any change.”
Although lumps can be painful to touch, Dr. Corgan said most cancerous lumps are not.
“However, there are no absolutes,” she said. “Though cancers are not commonly associated with pain, cancers can, in rare circumstances, hurt. If a woman feels a lump, she should consult a physician for diagnosis.”
Krengel had no family history of the disease but was diagnosed with Stage 2 estrogen receptor breast cancer.
“There are so many different types of cancer,” she said. “My cancer literally fed on estrogen.”
From November 2009 to March 2010, Krengel underwent chemotherapy, radiation and a lumpectomy. She has been on Aromasin, a hormone therapy that blocks estrogen, since April 2010 and will continue to do so for another two years. She said side effects, such as bone pain, result in some women not being able to continue the therapy, but she accepted it as part of her life.
“When you are diagnosed with breast cancer, your life changes,” she said. “When I was diagnosed with cancer, I was one person. I left that office another person. It affects your psyche.”
Of the whole experience, Krengel said she chose to be “sickeningly positive” rather than negative and angry.
“Be realistic,” she advises to others facing breast cancer — women and their families and friends. “It is what it is. Everybody has different ways of dealing with things. I rear up and go head-on with it.”
Krengel calls other women her “sisters in cancer” and said she has the utmost respect for them. She also encourages being informed about the disease and emphasizes self-exams.
“It can happen to anybody. Awareness is key to beating it,” she said. “Don’t be embarrassed to touch yourself and to feel your breasts. If I never did that, I would have waited a little bit longer for the mammogram — and who knows?”