For Lisa Early, getting a mammogram at age 40 was just a casual thought, and she didn't follow through.
Years passed, and the thought became a whisper. Eventually it turned into a throbbing yell when she started seeing less than subtle signs from the universe. She set the appointment after driving by a billboard with bold letters that simply read "Get a mammogram."
Tracy Dean also scheduled a mammogram. She had been doing the exam yearly and this year's was just another appointment, a routine checkup.
Neither of the Laguna Beach residents thought the test would yield meaningful results.
But Early, who is dating the Coastline Pilot's photo editor, received the news by phone while at lunch with friends. Dean went to a follow-up appointment with little preparation for the news she would hear.
Shell-shock, confusion, dismay — all are weak words that fall far short of describing the moment they were told, "You have breast cancer."
"The wind was knocked out of me, my feet came out from underneath me," Dean said, "I instantly got tears in my eyes and the first words out of my mouth were, 'Am I going to die?'"
With National Breast Cancer Awareness Month coming to an end this week, pink ribbons will slowly disappear, the NFL will strip its ranks of pink socks and shoes and the Oregon Ducks will retire their pink helmets.
But the battle against breast cancer will carry far beyond October for Early, Dean and many other Orange County patients.
Dean and Early, both 43, were strangers when their diseases were diagnosed just a month apart over the summer. Both have similar and aggressive forms of the disease and now, after being connected through mutual friends, rely on each other for support through treatment.
With calls and messages, they help each other through emotionally draining chemotherapy sessions and share an understanding of the "hung over, food poisoning and jet lag all at the same time" feeling and something they both call "chemo brain."
"I realized about the second chemo why they are called survivors," Dean said. "It's like you go to hell and then you crawl out of hell and say, 'OK, bring me back.'"
Both had their fifth of six chemotherapy treatments this week with a hardened resolve that they have worked to cultivate over the past few months.
Both women agree that facing chemotherapy is "hell." It started with losing their long, blond hair, which was a hurdle in itself and has only gotten harder as side effects worsen with each treatment. Despite the physical pain and the emotional trauma, both women have refused to let the diagnosis and treatment take over their lives.
"Don't let cancer define you," Dean said with a smile. "Don't let it get the best of you."
Early has continued to work as a marketing development manager with Coca-Cola despite medical complications and emotional struggles. At first, "I would cry, pull myself together and go into my sales meeting.
" Once I started treatment, [after a treatment] I would pull the car over, take a nap, then go back to work," she said.
Dean is taking time off work as a special event coordinator to start her own cancer registry and online forum called Can Survive Cancer. She already has a Facebook page, Team Tracy D, with more than 800 supporters who use the page to share stories and offer support to fellow patients.
Dean and Early are taking separate treatment paths. Dean underwent a mastectomy to remove the cancer while Early started with chemotherapy to reduce the size of the tumor.
Once Early finishes chemotherapy, she will have to decide whether to have a lumpectomy or a mastectomy. Dean will finish her chemotherapy just before Thanksgiving and has reconstructive surgery planned for December.
There is light at the end of the tunnel for both women. Dean expects to be cancer-free and off medications by May.
"What's kept me positive is that I'm going to be cured," Early said. "I'm going to live a long life. One year from now, it's going to be behind me."
"I am just grateful I caught it when I did," said Early, whose grandmother died from the disease.
Both preach the importance of early detection and getting mammograms. Dean has put fliers on her neighbors' doors and Early tells every woman, young and old, she meets.
If breast cancer is diagnosed in early stage, the survival rate is 98%, according to a study done by Susan G. Komen of Orange County and UC Irvine. If the cancer is caught at a late stage, as defined by having spread to the lymph nodes or adjacent tissue, the study shows a survival rate of 20%.
Julie Guevara, a marketing and communication manager at Susan G. Komen of Orange County, said that most health insurance companies won't cover mammograms for women under 40, adding, "If you know breast cancer runs in your family, talk to your doctor." She said Susan G. Komen has resources to provide free mammograms for the uninsured.
"Early detection is the key to surviving breast cancer," said Dr. Gary Levine, director of breast imaging at the Hoag Breast Care Center. "[Women] should have a baseline mammogram at age 40 and yearly mammograms afterward."
He said though the incidence of breast cancer is increasing — Orange County has a higher than average rate — it is one of the most curable forms of cancer when caught early.
Levine noted that if a woman has a family history of pre-menopausal breast cancer, she should talk to a doctor since experts recommend the start of screening at a younger age in those cases. For women of all ages, he recommended conducting monthly self-examinations.