Mi~Story by Cathy Ricketts

Cathy’s Story

In 2001, Cathy experienced the devastating loss of her mother, Lesley, to secondary breast cancer. With further incidences of breast cancer on her mother’s side, Cathy decided to be proactive and approach her GP regarding screening options at the age of 40.

After a risk calculation, and due to the age of Lesley when she was first diagnosed with breast cancer, Cathy was placed into the family history screening pathway, meaning she received annual mammograms from the age of 40.

Cathy attended each mammogram, and over the 10 years, she was recalled twice. The second time she was recalled, Cathy was told unofficially that she had ‘dense breasts’, but not what this meant. The imaging team also told her that they had found a ‘star-shaped’ region in her breast, which was investigated by a second mammogram and ultrasound. Cathy was given the ‘all clear’, and subsequent annual mammograms were completed without Cathy being called back for any additional screening.

At age 50, after 10 years of annual mammograms, Cathy started to notice symptoms - dimpling on her breast, a couple of weeks before her next scheduled mammogram. After the mammogram, further ultrasound screening and a biopsy, Cathy was diagnosed with invasive lobular breast cancer.  The tumour was initially estimated to be 7cm. Post a staging MRI, it was confirmed that the tumour was 9cm and that a mastectomy would be required.

Lobular Breast Cancer is a distinct type of breast cancer that has different characteristics and growth from the more common Ductal Breast Cancer.  Lobular makes up about 10-15% of invasive breast cancers and is the second most common form of breast cancer*.  Unlike Ductal Breast Cancer, Lobular Breast Cancer grows in a line or as single cells and rarely forms a lump, making it harder to detect on mammograms.

Cathy was informed that her tumour was classified as ‘slow growing’ according to the Ki-67 score (which indicates how fast tumour cells are dividing). Cathy has since learned through her research that the early stages of tumour growth could have been the ‘star-shaped’ area previously visible on a mammogram and investigated. 

Cathy was given the ‘all-clear’ in her last mammogram, 15 months before her diagnosis (an appointment which was delayed due to COVID).

Cathy was not aware she had dense breasts and what this meant until she was receiving treatment, and she specifically asked for her breast density classification and was told it was 3 or C, depending on the classification edition used. This is the second densest category, and studies have shown this classification to reduce the sensitivity of a mammogram (the ability to detect cancer). Cathy believes the combination of lobular cancer and breast density is why her cancer was not detected earlier. Had she known about dense breasts, she would have been more aware of the potential masking effects of dense tissue on a mammogram during her years of annual scans.

Since this experience, Cathy has been engaging with and supporting charities working to raise awareness for breast density and for Lobular Breast Cancer. After attending an in-person meet-up organised by the charity Lobular Breast Cancer UK, she met women with similar experiences, who were diagnosed at a later stage (stages 3 or 4) and whose lobular breast cancer had been missed on mammograms, often in ladies with dense breasts. Cathy is passionate about helping to change the breast screening guidelines related to breast density.

Cathy is now four and a half years post-diagnosis and pushed her medical team to provide annual MRIs privately alongside her mammograms, due to her dense breast tissue and the distinctiveness of lobular breast cancer.

“I am fortunate to be in a position where I receive annual MRIs and mammograms for ongoing monitoring; however, I know many women who have had lobular cancer who struggle to get additional MRI screening, even though this is often recommended as the gold standard for monitoring for lobular breast cancer. I believe women who have dense breasts are being underserved in the current screening and monitoring pathways with mammography alone”

-              Cathy Ricketts

For more information on lobular breast cancer, please visit https://lobularbreastcancer.org.uk/ or https://breastcancernow.org/about-breast-cancer/diagnosis/types-of-breast-cancer/invasive-lobular-breast-cancer

For more information on breast density, please visit our ‘Breast Density’ page.

* https://www.bcrf.org/about-breast-cancer/invasive-lobular-carcinoma/