As Breast Cancer Awareness Month begins, MAXINE GORDON speaks to a York survivor with a positive message

RACHEL BIRCH wears the pink ribbon every day - she has had the symbol of breast cancer awareness tattooed on her shoulders.

In the design, the loop of the pink ribbon replaces the 'r' in 'survivor' - and a pink butterfly hovers as the dot above the 'i'.

Having the word survivor inked on to her skin felt empowering for 50-year-old Rachel, who was diagnosed with breast cancer just 12 months earlier.

"When I got the all clear after my first year, I wanted to commemorate it," says Rachel, who lives in York with husband Paul and son Joshua. "I'd been to hell and back. I am proud of going through it. There is nothing to be ashamed of or embarrassed about."

Rachel feels fortunate she was diagnosed in the first place. She had no symptoms, but had been called for a mammogram as part of a pilot test on women aged 47-49 in York. The regular screening programme covers women aged 50-70.

Her mammogram result was suspicious and led to a biopsy from which doctors diagnosed stage two cancer. The tumour was 2.8cm in size and later tests revealed it had spread into one lymph node.

Rachel had surgery to remove her right breast and all the lymph nodes from her right arm, followed by six weeks of chemotherapy.

It was gruelling, but Rachel tried to keep focussed: she was alive.

"If I hadn't had that test, doctors said that I might not have survived to see my 50th birthday," says Rachel who celebrated the actual event by going on holiday to Benidorm with her sister.

One of the hardest parts of her cancer treatment was adapting to how her body was changing. Not only had she lost her right breast, but her hair had fallen out as well as her eyebrows and eyelashes.

During her first chemo session, Rachel wore an "ice-cap" in an attempt to combat hair loss. "It's like wearing a riding hat that freezes your head to stop your hair follicles falling out." She found this unpleasant and ineffectual. "Within one week of my first session my hair started coming out in handfuls. It was soul destroying."

Rachel couldn't face going to her hairdresser. "I couldn't go there with my hair falling out and ask them to shave my head while everyone else in there was having highlights or a hair cut."

Instead, she visited the hair salon at the Cancer Care Centre at York Hospital - right after her second chemo session - and asked for them to take all her hair off. It was strangely liberating, she said. "Once it was gone, I thought: 'right, it's gone, deal with it'. At least I stopped worrying about my hair falling out."

Rachel invested in a collection of scarves and hats and began experimenting with her new look. "I bought 25 scarves in all sorts of colours and even a bowler hat that looked quite trendy. I watched YouTube videos on how to wear scarves on your head."

She had a few wigs too, but found them too hot to wear during the day, so saved them for when she went out in the evening.

The treatment took its toll. Rachel was off work for eight months. All the while she was determined to stay positive and win her life back.

"I was in auto pilot mode. I just told myself I was going to get better," she said.

For five days after each chemo session she would feel terrible, but she knew she'd get better, and she would look forward to that.

"I'd go out shopping or meet my son on his day off for a burger, " she said.

"I'd keep myself looking smart and put on a bit of makeup - it always made me feel a little bit better."

For her last chemo session, Rachel turned up in a pink hoodie on which she'd written in felt pen the date and a score: "Rachel 1 Cancer 0".

Later this month, she will return to hospital for breast reconstruction surgery - one year on from her mastectomy.

She said: "Wow, I've done it. I look at my scars and I don't like them but I am here.

"I try not to think too hard about the past or I'll break down in tears. I keep looking forward."

York Press:

Breast cancer - fact file

Every year, nearly 55,000 people are diagnosed with breast cancer in the UK, that’s the equivalent of one person every ten minutes.

One in eight women in the UK will develop breast cancer in their lifetime.

Breast cancer is the second most common cause of death from cancer in women in the UK.

Nearly 12,000 people die from breast cancer in the UK every year.

Breast cancer also affects men, but it’s rare – around 400 men are diagnosed each year.

More than 80 per cent of breast cancers occur in women over the age of 50. Most men who get breast cancer are over 60.

Around five per cent of people diagnosed with breast cancer have inherited a faulty BRCA1 or BRCA2 gene.

More than eight out of 10 (85 per cent) people survive breast cancer beyond five years.

Source: Breastcancercare.org.uk

How to check your breasts

The charity Breast Cancer Care has this advice: There’s no right or wrong way to check your breasts for any changes. Try to get used to looking at and feeling your breasts regularly. You can do this in the bath or shower, when you use body lotion, or when you get dressed. There’s really no need to change your everyday routine. Just decide what you are comfortable with and what suits you best. Remember to check all parts of your breast, your armpits and up to your collarbone. When you check your breasts, try to be aware of any changes that are different for you.

These could be:

A change in size or shape

Redness or rash on skin or around the nipple

Discharge from the nipple without squeezing

Swelling in armpit or around collarbone

A lump or thickening that feels different from the rest of breast tissue

A change in texture, such as puckering or dimpling (like an orange skin)

Nipple inverting or changing shape

Constant pain in breast or armpit.