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  • Writer's pictureMiriam Diaz-Gilbert

The Beginning of My Cancer Journey: Had I Not Fallen on an Uneven Sidewalk, I Would Not Have Known I Have Breast Cancer

Updated: Jul 2

Photo: Jon Gilbert

On March 25, 2024, on a sunny, chilly Tuesday afternoon under a bright blue sky, I headed to the supermarket two and a half miles from home in my fleece jacket, black running tights, and a headband. At about two miles while walking on a sidewalk of a two-lane county road, I took my eyes off the sidewalk when I noticed a slow-moving vehicle on the shoulder of the lane as it approached the sidewalk curb. I thought the motorist was going to ask for directions.

And then it happened. BAM! I tripped over the uneven sidewalk and I fell hard on the right side of my body. I felt my right rib land hard on the raised edge of the concrete slab. I felt the sting of a scrape on my right knee. I scraped the palm of my right hand. My mouth whispered an expletive. Thanks to my strong core but slightly embarrassed self, I got up quickly,

The motorist, an older white-haired male wearing sunglasses, and his dark blue car were still there. He had watched me fall and get up. He lowered the passenger side window. He didn't say a word. I said, "Are you lost?" He shook his head and gestured with his left hand indicating he was going to turn right. All I could say was, "I'm fine," and continued on my walk to the supermarket.

I called my husband Jon to let him know I fell and why I fell.

When I got to the supermarket, I went to one of the stalls in the ladies' room. I pulled down my black running tights. The area below my right knee was scraped and bloody. A vein or two on my right wrist was bruised. I had an abrasion on my right palm. Tiny pieces of skin were coming off. My right rib was not bruised or scraped but sore. I pulled my sports bra up. My right breast was not bruised.

I walked in discomfort in the supermarket aisles to grab cat food, dark chocolate chips, and a roll of paper towels. I paid for the items at the self-checkout and carried them in my Dawn to Dusk to Dawn swag knapsack.

I walked home under the bright sun and against the gentle wind on a blue sky afternoon. The nice weather helped to lessen the sting of my bloody knee and the bruised sensation on my right rib.

By the time I got home, I had collected five miles on my Garmin. Jon cleaned my knee and applied Aquaphor healing ointment (we had run out of Neosporin). He covered the area with a gauze bandage. I applied a Ziploc bag filled with ice cubes on my knee and another one on my rib area. I applied a baggie of ice on my right wrist. I rested my body in the recliner and ate lunch with my left hand.

I began to feel greater discomfort and pain when I got up from a sitting position, when I sat down, when I laughed, and when I sneezed. Lying down in bed and getting up from the bed was painful. I could not sleep on my right side. Turning on my left hurt. I applied ice and a heating pad, and used a variety of pillows. I applied CBD roll on, I massaged Tiger Balm in my rib area and below my breast. I took Aleve. Nothing brought me relief.

I was training for the Dawn to Dusk to Dawn 24-hr track ultra, which was seven weeks away. A week after my fall, my knee was almost healed and a scab formed, but my rib area grew increasingly sore and painful with movement but showed no signs of bruising.

On April 1, a week after I fell, I called my primary doctor and told her what had happened, and that I wanted to make sure I hadn't fractured my rib. I had an office visit and an x-ray immediately. The x-ray showed I did not have a rib fracture and that my bone mineral density was appropriate for my age. I'm 65. I was relieved I did not have a fracture and that I have good bones.

The discomfort persisted, but it didn't stop me from collecting slow walking or running miles. However, the area underneath my right breast began to experience more discomfort. Sleeping was difficult. It was now two weeks since I had fallen.

I thought maybe my right breast might be bruised internally. I decided to schedule the yearly mammogram I should have gotten in October 2023. During my yearly physical in October 2023, I told my primary doctor that I wanted to skip my mammogram this year. Due to my physical fitness, the fact that I'm an ultrarunner, and eat well, she supported my decision. And while I have had two biopsies on my left breast twice in a twenty-year span, the last one being In 2008, every year since then I've gotten good news after a mammogram— "You have dense breasts. You have a normal mammogram."

I made an appointment to make sure that my right breast was fine, just like my right rib.

I got my bilateral screening mammogram on April 8, two weeks after I fell. The next day, I got a message on my patient portal from my primary doctor —"Mammogram results show new abnormalities of the right breast. Radiologist recommends additional images." The radiologist report indicated I have "right breast calcifications." The mammogram images were flagged abnormal.

The next day, I scheduled another mammogram, this time a diagnostic tomosynthesis of my right breast. I was given an appointment for May 25. I said no and that I wanted an appointment ASAP. I was told to call the next morning between 8 and 8:30 am when cancellations come in. I called at 8 am and got an appointment for April 11.

The results of this mammogram indicated "fine linear or fine-linear branching calcifications in a grouped distribution seen in the upper central region of the right breast in the posterior depth. Compared to the previous study, the calcifications increased in number." I googled "fine linear or fine-branching calcifications." I learned that calcifications larger than .5 mm and not clustered in one area of the breast are generally benign. But smaller, clustered calcifications indicate a cancer process.

On April 25, I had a stereotactic biopsy. I sat upright on a chair. The radiologist removed twelve samples, seven of them calcifications. On May 1, ten days before the Dawn to Dusk to Dawn 24-hr track ultra, I got the results of the biopsy —"The pathology findings are malignant.The ductal carcinoma in situ intermediate nuclear grade is concordant with imaging." The radiologist called me to explain the results. She said I would need to see a breast surgeon next. I asked for a female breast surgeon and she recommended one of the best.

I immediately shared the results with Jon. And then I googled ductal carcinoma in situ.The nurse navigator called me to explain the biopsy results and all the technical jargon, and the next steps, including meeting with a genetic counselor, getting genetic testing, scheduling an appointment with the breast surgeon, and with a radiation oncologist and a medical oncologist, both female too.

Everything happened so fast. In a span of six weeks, I fell, I got an x-ray of my rib, two mammograms, and biopsies. I learned I have breast cancer that was caught early. I was relieved.

Jon and I met with a genetic counselor, also female and very compassionate. I got genetic testing. The genetic counselor put a rush on it. I have some family history with cancer. A maternal cousin died of breast cancer and a maternal cousin died of ovarian cancer. I have a paternal cousin who is a breast cancer survivor. I am happy to say that the results of the panel of genetic tests indicate I do not have a gene mutation.

On May 9, Jon and I met with the breast surgeon. I got pre-admission testing in preparation for surgery. The day after I tackled the Dawn to Dusk to Dawn 24-hr track ultra on Mother's Day (May 11-12) weekend, a Savi Scout, also called a Savi seed and the size of a grain of rice, was implanted in my right breast where the cancer is located. This will help the surgeon to find and remove the cancer.

In between all these appointments and training for my thirty-ninth ultra, I educated myself. I googled as much as possible about DCIS, which is very common and very survivable because it is non-invasive.

According to the Breast Cancer Research Foundation (BCRF), of all the breast cancers diagnosed in the US, 20-25 percent are DCIS. Approximately 55, 720 cases of ductal carcinoma in situ will be diagnosed in women in 2024. Breast cancer affects men too. Approximately 2,790 cases of male breast cancer will be diagnosed in 2024.

I learned that Martina Navratilova and Sheryl Crow are DCIS survivors. ESPN anchor Hannah Storm was diagnosed with DCIS in March. Female athletes, ordinary and professional, have survived breast cancer and continue to engage in the sport they love.

And now I wait for my partial mastectomy on June 3. It's an outpatient procedure. My surgeon said it will take about thirty minutes. I'll wait for the pathology report. I will meet with the radiation oncologist and the medical oncologist. Then I'll know if I will need radiation.

We never know what kind of curve ball life will throw at us, but I will say that I am so grateful for that fall on that beautiful spring day on March 25. When I fell, I was a bit annoyed with the motorist whose driving too close to the curb caused me to take my eyes off the uneven side, because I thought he was going to ask me for directions. If he had never driven so close to the curb, I would not have fallen and not know that I have breast cancer.

But upon reflection, I now know that that man was really an angel sent by God. The fall was a hard nudge to get me to get my mammogram now and not to wait until October 2024. Who knows what stage breast cancer would be waiting for me if I had waited until October. I believe that man who spoke no words, that angel, saved my life.

I am very fortunate and grateful that I have access to excellent medical and cancer care at one of the top teaching hospitals and cancer treatment centers in the United States. It's the same place where Jon received top cancer care twice for stage IV colorectal cancer. Please don't delay your colonoscopy. Jon is in remission and doing well.

And ten days after getting my diagnosis, I placed 7th female at the Dawn to Dusk to Dawn 24-hr track ultra. Here's my race report.

Photo: Jon Gilbert

I am going to be fine. I am so grateful my cancer was caught early. Please don't delay your mammogram. Schedule it today.

This is the first post in a series of blog posts documenting my breast cancer journey. Stay tuned for my next blog post. I will share my surgery and recovery.

Read about my surgery, recovering, being cancer-free, and my decision to opt out of endocrine therapy and radiation here.


I am also the author of Come What May, I Want to Run: A Memoir of the Saving Grace of Ultrarunning in Overwhelming Times. You can order the book exclusively from the Wipf and Stock Publishers website, use code ultrarunning40, and receive a 40% discount. Offer expires 9/3/24. You can also order It on Amazon, Bookshop, or Barnes & Noble. It's available in hardcover, paperback, e-book, and Kindle.

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