We meet outside the social welfare office at Kungsholmen in Stockholm. Cecilia is 52 years old and has started working full-time again as a social secretary. She pulls the dark blazer tighter around her as we stroll along the canal.
The steps are calm, steady. But when she starts talking about the summer of 2023, the voice changes. We stop by. She brings her hand to the two small gold charms around her neck. The sons' names are engraved on the front. On the back is "mother" and a small heart.
- I had them done that summer, right after the announcement. I thought my boys would get them as a memory if I was no longer around, she says.
It started with a soreness in the breasts. Something diffuse, easy to dismiss. Cecilia thought it was hormonal. At work there was a lot, the days passed quickly, and the mammography appointment in May was rescheduled. Only ten days. She almost pushed it back up, but she left.
During the examination, she reacted to the fact that the staff took more pictures than usual. She doesn't remember anyone saying anything in particular, but since that day Cecilia felt a worry that followed her from there.
A few days later, the letter was in the mailbox. The date was June 20. Her youngest son turned nine that day.
- I remember reading it on the way up from the farm to collect his birthday cake.
- I was freezing cold. It said that the images showed inaccuracies and that they needed to do a new investigation. I had to put all my strength into holding myself together for the children and the party that day.
Then followed the wait. New research. Sampling. And then, on July 5, 2023, the news at Capio St. Göran's Breast Center: the tumor in her right breast was aggressive and fast-growing. The cancer had already spread to the lymph nodes in the armpit.
- I completely broke down. It felt like the rug was pulled out from under my feet. I was struck by a completely gas-hugging death anxiety. How could this happen to me? There was no heredity in the family. All the women on my mother's side have lived to be 95.
What followed was just over six months of chemotherapy, surgery and 15 radiation treatments. Time took on a different rhythm. The days were arranged according to treatments, phone calls, test results and side effects. Before chemotherapy began, Cecilia bought a trimmer. She let her youngest son help her shave her hair.
- I wanted to involve the children and try to de-dramatize the situation.
During the same period, a new way of working had just begun to be used in the hospital's operations for breast cancer screening. Capio St. Göran's hospital is, according to the hospital, the first in the world to replace one of two examining radiologists with an AI algorithm, artificial intelligence, in clinical routine operation.
Senior physician and breast radiologist Karin Dembrower has led the Screen Trust CAD study, which includes over 55,000 women in Stockholm.
- We radiologists tend to agree with each other and we see the same things with our eyes. But we don't know what we don't see and that's where the AI review complements us. The AI algorithm finds different types of cancer than the human eye can perceive, she says.
According to the hospital, Capio St. Göran now finds about seven cancer cases per 1,000 women examined, compared to the national average of four to five. Above all, 50 percent more invasive cancers are detected, which affects the treatment.
For Cecilia, it took time to get used to the idea that artificial intelligence had been part of the path to her diagnosis.
- At first I was skeptical when I was told that AI was involved in diagnosing my cancer. But when I learned that the images are always reviewed by at least one doctor, I felt safe. I really hope AI becomes a sharper tool. Early detection is actually the difference between life and death.
But when she talks about her time as an ill person, it is not primarily the technology that she comes back to, but the people. The same contact nurse throughout the entire process. The same two doctors. A direct number to call when the worry became too great or the side effects unmanageable.
- They always called back within fifteen minutes if I was worried. I have friends who have been treated at other hospitals in the region and their care has been far more fragmented.
Karin Dembrower describes the hospital's flat organization as an important explanation for the fact that it has been possible to bring research into clinical operations in a short time.
- We have a creative, efficient and positive working climate with the greatest focus on the patient and science.
She also shows how the population has been divided into different flows so that the women who come for a health examination come to a part of the hospital dedicated only to the health examination of the breasts, while the women who are recalled from the screening, have symptoms from the breasts or are undergoing/after treatment for breast cancer come to another unit.
- Being recalled from the health examination or experiencing symptoms from the breasts is often associated with great concern.
The treatment put Cecilia straight into menopause. The relapse prevention treatment is still ongoing and the side effects are part of everyday life.
- It was like a slap in the face. I still struggle with joint pain, swelling and dryness every day and I need more time to recover than before. I have had to work a lot with acceptance and I am extremely grateful that the treatment exists.
- I have not yet received a formal "health stamp". But what they can say, however, is that I am now considered cancer-free.
When she looks back on the time surrounding the announcement, it is the children that she talks about the most. During the time she was ill, the sons stopped arguing.
- They wanted to spare me and carried a silent, heavy concern. When my hair finally started to grow back and I looked healthier, the first regular sibling fight came in a long time. It was an absolutely wonderful relief. Then I knew that they were no longer constantly afraid that I would disappear.
Today, Cecilia walks a lot, goes to yoga and tries to pay more attention to and take care of her body. She's not talking about any easy way back. Rather about a different way of looking at life.
- The outlook on life has changed. I can never relax anymore. It's always in the back of your mind that anything can happen at any time without warning. The illusion that you have control over life is gone.
Everyday life, she says, doesn't look the same anymore. It means more.
- The awareness of the fragility of life is somehow bittersweet for me. I appreciate everyday life in a completely different way now. I am so incredibly grateful for every day I get to be with and experience my children's lives.
