Megan Smith thought it was a strain when she woke with pain in her right arm. A lump she had found earlier on the edge of her chest didn’t seem to be connected. As a nurse at Doctors Hospital, she went to a co-worker and said, “Am I crazy or is this something to worry about?
“She said, ‘Call your doctor right now.’ ”
But because she is only 26 years old, no one thought the mammogram would turn up anything to worry about. But on Aug. 1, she got the call that it was breast cancer. With 4-year-old twins and a husband who returned earlier this year from a deployment in Iraq, she suddenly found herself facing major decisions and major surgery. Luckily for her, her family and seemingly an entire community in Beech Island, North Augusta and beyond are rallying around her.
She is not the typical breast cancer patient. Besides gender, the next biggest risk factor for breast cancer is age, with 95 percent of cases occurring in women ages 40 and older, according to the American Cancer Society. A woman age 20 has a .06 percent chance of developing breast cancer in the next 10 years, or odds of 1 in 1,760, according to the cancer society. That is more than 50 times the odds of guessing the correct number on a roulette wheel. Like many of the estimated 230,480 women who will get breast cancer this year, she had no family history of breast cancer. But she also did not have many other risk factors.
“It’s the oddest thing ever,” said her mother, Cynthia Rollins. “She’s 26, she breastfed, she’s never smoked. She’s just the rarity to get this.”
Because she is a young mother, she decided to have both breasts removed to lessen the odds she will ever have to face it again.
“I’m 26. I can get through this and I don’t want to have to worry about it, worry about it coming back in the left breast 20 years from now,” Smithsaid.
“Because it will always be in the back of your mind,” said her best friend, Nichole Glover, who is with her for a visit to the Breast Health Center at University Hospital. Her grandmother, Nancy Rollins, is also there and she is worried about Smith’s twins, Lexi and Lucas.
“They are the smartest little things so they know things are going on,” she said.
“I haven’t really tried to explain that to them, just that Mommy is sick and Mommy is going to have to go to the doctor a lot and Mommy is going to have to go to the hospital,” Smith said. “My mom and my dad and my husband have been telling them you’re going to have to be easy with Mommy. You can’t be jumping on Mommy.”
Smith’s grandmother, parents and other relatives live around each other in Beech Island and are ready to lend a hand, Nancy Rollins said.
“I kept them a lot when her husband was in Iraq,” she said. “And plus I live real close, very, very close.”
“Right around the corner,” Smith said.
“And I’m retired so I’m there all the time,” Nancy Rollins said.
“You’re lucky,” said Pam Anderson, the director of cancer services for University.
In fact, the pre-op room at University is crowded as Smith waits to be wheeled back to the operating room. She looks tired.
“I stayed up way too late,” Smith said. “Then, 2 o’clock when I tried to lay down, Lexi woke up with a nightmare. I lay in her bed until she went back to sleep, and then she woke up again and I ended up putting her in the bed with me and (husband) Jason.”
“Where are your kids?” Anderson asked.
“The fire chief has them right now,” Jason Smith said. “I’m on the Beech Island Fire Department.
“That’s the beauty of a small community,” Cynthia Rollins said. “Everyone wants to help.”
Jason Smith holds up his phone, with a picture of the twins riding on the fire truck.
“Awww, that is sweet,” Megan Smith said. “Look at those faces.”
She makes her husband get in touch with fire chief Justin Craven so she can talk to them before she goes under.
“We’re in the fire truck,” Lucas tells her, loud enough for those in the room to hear.
“Are you having fun? Are you having fun, Bubba?” Megan Smith asked.
“I’m so glad. You be good for Mr. Justin, OK?”
As a nurse who preps people for operations, she knows exactly what is coming.
“I think it is better, knowing,” Megan Smith said.
Inside the operating room, Dr. Dan Duggan Jr. works quickly, basically peeling back the breast tissue from the skin to create a pouch. Then plastic surgeon Dr. Billy Lynn will fill them with tissue expanders, that can be slowly filled over time to stretch the skin and later be replaced with implants.
Duggan said he has had four patients this young in 28 years of practice, and he is not surprised she opted to have the other breast taken as well.
“These young women have so long to live that most of them just go ahead and do it,” he said.
As he works to pull off the breast tissue, he finds the tumor nearly all the way over in the armpit and can feel it a little more solidly on the backside of the breast tissue.
The biggest question is whether there is any involvement of the nearby lymph nodes, which will determine whether or not chemotherapy would be recommended. As he pulls the lymph nodes out, he feels them and he is a little cagey about whether any feel suspicious.
“I’m not going to be surprised,” he said.