A Breast Cancer Survivor’s First Brush with Skin Cancer

Self-checks for skin cancer, as well as regular check-ups with a dermatologist, are important for breast cancer survivors. A recent self-check led me to detect my first pre-cancerous lesion, which has made me even more mindful.

After having breast cancer, I always enjoyed my annual visit to the dermatologist. This check-up, despite sun-damaged and aging skin, was for years a source of celebration. Born into a family with all kinds of skin cancer, from melanoma to basal cell, I felt lucky. Approaching 70 years of age I experienced my first actinic keratosis.

Actinic keratosis, not uncommon, is a precursor to squamous cell carcinoma, something I am familiar with from my mother’s experience with that (including skin grafts after surgery). A sister cancer to the other common skin cancers, melanoma and basal cell carcinoma, it is ideally found early (as all cancers are). I found my tiny pre-cancer myself because a spot on my forehead seemed different from a non-cancerous seborrheic keratosis lesion (of which I have my share).

At first, I did think the spot was simply a seborrheic keratosis, but I am not a doctor. As the lesion evolved, I made an appointment with my dermatology office, which allows very little notice for a “spot check,” before I was due for an annual. A physician’s assistant checked me out and told me what was going on. She froze the keratosis on the spot. After a few weeks of Vaseline smears, it fell off. Throughout the episode, though, I still celebrated my good fortune in the dermatology department.

That is because I recognized the issue before it really became an issue. Being proactive is always good. I am thankful to my parents for their experience with not just bladder and breast cancers but also for their commentary on their experiences with skin cancer, which made me seek annual check-ups from about the age of 35, and then this spot check. Along with their genes, I shared habitats, including an idyllic six years as a child on the coast of North Carolina without witnessing much sunscreen (save zinc oxide on the noses of surfers and lotions tourists slathered on). So much sun damage that can lead to skin cancer will happen before we are adults.

Despite starting to wear sunscreen in my 20s when my mother, especially, began dealing with multiple skin cancers in her 50s, there were years of sun damage that needed monitoring. Then, after radiation for breast cancer, annual visits to the dermatologist became even more important because changes can occur in the area radiated. These can include the triad of common cancers (basal, squamous, melanoma) as well as hemangiosarcoma. Actinic keratoses can appear too, especially as time passes, so my dermatologist shines a light on my mastectomy site along with everywhere else each time I visit.

In addition, the chance of getting skin cancer elsewhere on a body increases with radiation. As for my actinic keratosis? I cannot know if it was a result of a sun-filled childhood or radiation or both. It does not matter at this point. I will simply continue self-checks of my skin in between annual checkups. As I am not a professional, though, I recommend learning more from the CURE article “Breast Cancer Radiation May Increase Skin Cancer Risk” and “Dermatologic Toxicities Associated with Radiation Therapy in Women with Breast Cancer” by J.Y. Ramseier and others.

This piece reflects the author’s personal experience and perspective. For medical advice, please consult your health care provider.

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