Starting at 30, she began with mammograms. Those turned out clean until six months after the birth of her and David’s first child, a little girl named Malia, who is now 5. Langer lost her mother when 16 and grandmother while in college, both to breast cancer. She wasn’t taking any chances and opted to get a bilateral mastectomy. This was the first battle for Langer, who has had two bouts with breast cancer.

“I’ve always had a feeling that something was going to happen. I didn’t know how or where it would materialize,” Langer said.

Breast cancer is the second leading cause of cancer death in women, meaning the chance a woman will die from breast cancer is 1 in 35. One in eight women will develop invasive breast cancer at some time in her life. This year, the American Cancer Society estimates 40,170 women will die from breast cancer. That being said, the incidence rate decreased about 2 percent annually from 1999 to 2006. Death rates began declining in 1990, particularly among women younger than 50. Earlier detection through screening and awareness is thought to be responsible for the decline.

Langer’s mother began teaching her abnormalities to look for in her breasts at a young age. Her family history led Langer to begin mammograms early, which helped detect cancer quickly. Today, Langer is a resource for women in the community, an advocate of women to know their own body and not be afraid to ask questions.

Her first round with cancer resulted in a diep flap surgery, in which tissue from her stomach to rebuild her breasts.

“The silver lining was a got a tummy tuck and a breast lift,” she said.

Langer and her husband had difficulties when it came to having a second child. Once pregnant with her now 2-and-a-half-year-old son Ari, Langer got regular check ups. One of those check ups results in the discovery of a pebble-sized bump in her left breast, which was positive for cancer. After much research, Langer decided to go forward with the first round of chemo while pregnant. Not having research on the effects of the second rounds of chemo on a fetus, Langer held off on the second round until after giving birth.

Ari was born on Langer’s 39th birthday by caesarean section. He was a healthy, vibrant little boy. Two weeks later, Langer continued with her treatment. Her final treatment was in April 2008.

There is always a chance for the cancer to return. While healthy, Langer has become a strong resource for those in community, willing to take calls and talk to strangers about her experience.

“If I can help just one person through their experience, then my experience was not for nothing. If I make one person feel a little more comfortable, there was a reason for my journey,” she said.

The incidence of cancer means Langer’s story is sadly far from unique.

Connie Norton, a San Francisco resident who grew up in San Mateo, received a letter asking for a follow up after her annual mammogram in 2003. She was 41 at the time, but wasn’t worried about the request.

“It had never seriously crossed my mind that I might be susceptible to breast cancer because none of my sisters, mother or maternal grandmother had ever had it and I certainly wasn't post-menopausal.  It wasn't until after my own diagnosis that I learned that only a small percentage of women afflicted by breast cancer actually have a family history.  My second mammogram confirmed the unthinkable:  I had ductal carcinoma in situ in my right breast and required surgery,” she said.

She had no cancer present in her left breast. However, noting the chance of developing cancer once she had it, Norton decided to go forward with a double mastectomy.

“Ultimately, I'm glad I did because the impacted area was larger than had been detected by the mammogram and there was a second lesion the mammogram hadn't identified,” she said.

Both Langer and Norton found reason for their experience through volunteerism.

For Langer, that work comes with Avon supporting research and sharing her story with people like those at Genentech working on treatments that help women like herself.

For Norton, it was becoming an active volunteer and fundraiser for the San Francisco Bay Area affiliate of Susan G. Komen for the Cure. This year, Norton was named the San Francisco Soft and Strong Champion by Quilted Northern, a recognition of volunteers who made the Susan G. Komen Race for the Cure in September possible.

Heather Murtagh can be reached by e-mail: heather@smdailyjournal.com or by phone: (650) 344-5200 ext. 105.

How to examine your breasts

Lie down and place your right arm behind your head. The exam is done while lying down, not standing up. This is because when lying down the breast tissue spreads evenly over the chest wall and is as thin as possible, making it much easier to feel all the breast tissue.

Use the finger pads of the three middle fingers on your left hand to feel for lumps in the right breast. Use overlapping dime-sized circular motions of the finger pads to feel the breast tissue.

Use three different levels of pressure to feel all the breast tissue. Light pressure is needed to feel the tissue closest to the skin; medium pressure to feel a little deeper; and firm pressure to feel the tissue closest to the chest and ribs. It is normal to feel a firm ridge in the lower curve of each breast, but you should tell your doctor if you feel anything else out of the ordinary. If you’re not sure how hard to press, talk with your doctor or nurse. Use each pressure level to feel the breast tissue before moving on to the next spot.

Move around the breast in an up and down pattern starting at an imaginary line drawn straight down your side from the underarm and moving across the breast to the middle of the chest bone. Be sure to check the entire breast area going down until you feel only ribs and up to the neck or collar bone.

There is some evidence to suggest that the up-and-down pattern is the most effective pattern for covering the entire breast, without missing any breast tissue.

Repeat the exam on your left breast, putting your left arm behind your head and using the finger pads of your right hand to do the exam.

While standing in front of a mirror with your hands pressing firmly down on your hips, look at your breasts for any changes of size, shape, contour, or dimpling, or redness or scaliness of the nipple or breast skin. (The pressing down on the hips position contracts the chest wall muscles and enhances any breast changes.)

Examine each underarm while sitting up or standing and with your arm only slightly raised so you can easily feel in this area. Raising your arm straight up tightens the tissue in this area and makes it harder to examine.

Source: American Cancer Society