Nurse practitioner Paula Kelleher gets to deliver a lot of good news about breast cancer at the Breast Care Center at Kaiser in Santa Rosa, Ca. In fact she gives out more good news than bad, which is surprising since the patients she sees dread the worst. Their worry level, she says, ranges from “some anxiety all the way to literally terrified and making out their will.”

In spite of advances in diagnosis and treatment of the disease, more political advocacy for research and a huge boost in public awareness about breast cancer Kelleher sees “a greater level of anxiety in women.” Ironically she thinks much of that fear stems from all that awareness.

Public attention on breast cancer has moved politicians to make the disease a funding priority. It has motivated women to do self exams and get mammograms. Breast cancer continually gets media play. The flip side, said Kelleher, is that women think, “Oh my God, I’m going to get it too.”

Happily she gets to report to the vast majority of patients that they do not have breast cancer. And that’s a lot of relieved women, considering that Kelleher sees an average 12 women a day at Kaiser who come in worried about a lump, a breast pain, a family history of cancer, a questionable mammogram, a request by their physician for further evaluation and just plain fear that they’ve got it.

“Love your breasts. Don’t fear them.”

Kelleher has worked in women’s health her whole career. She remembers when breast cancer was a secret diagnosis, before pink ribbons everywhere and survivors running marathons. Breast cancer is still the most commonly diagnosed cancer in women, says Kelleher, and she believes “every woman with a concern needs to be evaluated. But she says, “I just wish they didn’t have to be so afraid.”

Kelleher quotes Dr. Susan Love, the famous author, surgeon and breast cancer activist, who says that women think of their breasts as the loaded guns on their chest. To counter that, Kelleher tells patients, “Love your breasts. Don’t fear them. They’re probably okay. And even if they get diseased we’ll deal with it.”

Kelleher is not being Pollyanna about what she knows is “a very real and devastating disease.” But she adds, “Sometimes it’s spun like it’s inevitable.” Middle aged women, especially, assume that breast cancer is coming to get them and Kelleher thinks that’s because Baby Boomers are now in the age group, from 50 and on up, that is a risk factor for breast cancer.

“There’s more of us,” said Kelleher, age 55. “We see the neighbor, a relative, a friend getting breast cancer and that probably’s because so many of us are in that age group.”
Yet, even women of that age group can relax a little, she says. If there are no other risk factors women in their 50s have a 98 percent chance of getting to their 60s without breast cancer.
Kelleher tells patients they can go to Vegas with those odds.

Her optimism doesn’t just come from being a professional. Kelleher herself had breast cancer. So did her mother, great aunt and a sister. “And we’re all alive,” says Kelleher. Kelleher was as shocked as any other woman who gets the diagnosis. Then she sat down with her surgeon and decided that her best plan was a lumpectomy and radiation.
That was 17 years ago and there’s been no recurrence of cancer.

She tells her story to those women she has to give the bad news – that their biopsy is positive. And then she says, “Let’s get this treated so you can go back to enjoying life.”