Rachel Marie W. Fields' doctor didn't think she would be alive today.
The Charleston native was diagnosed with breast cancer back in 1974. At the time, she explained, the world didn't know as much as it knows now about breast cancer. After getting a mastectomy that same year, she said her doctor told her that her life expectancy would be 10 years.
She turned 77 in July and has been cancer-free for well over four decades.
“And I’m still thanking (God) every day, at least three times a day," said the retired nurse. "It worked out the way I said it would."
Since the 1970s, breast cancer treatment has changed significantly. Fewer physicians are solely doing radical mastectomies for treatment, and mortality rates are much lower. In South Carolina, the mortality rate for black women with breast cancer was 31.5 deaths per 100,000 women with breast cancer between 2002 and 2006. That rate dropped to 29 between 2011 and 2015 according to the American Cancer Society.
For white women, the rate decreased from 22.8 to 20.5.
According to the National Breast Cancer Foundation, radical mastectomies also are less common. Those procedures involve the removal of the whole breast, chest wall and lymph nodes related to the armpit.
Now, procedures like lumpectomies and partial mastectomies are more commonly considered. While the rate of mastectomies has increased over the years, experts with the Annual Review of Medicine note that in many cases, the procedures are patient-driven from fear of occurrence or re-occurrence of breast cancer.
This is due to doctors being able to pinpoint people who are genetically predisposed to breast cancer.
"Genetics is certainly one area of huge progress," said Dr. Stan Wilson, a surgical oncologist and chief medical officer with Roper St. Francis Physician Partners Surgical Oncology.
Wilson specializes in breast surgery. He said another area of breast cancer treatment that has evolved is that doctors are able to detect the cancer earlier when it is more confined.
"It's been much easier to find smaller breast cancer," he said. "More than 80 percent of breast cancer is localized to one area."
The 5-year relative survival rate of women with breast cancer is 90 percent, according to the American Cancer Society. For localized breast cancer, meaning it hasn't spread, the survival rate is 99 percent.
Wilson said his patients are always surprising him with their ability to get through some of the toughest treatment odds, especially when they are able to catch it early.
"That's ... the happy part for me," he said.
Linda Kay Wilson, 71, was diagnosed with breast cancer later in her life. In June 2017, she saw her doctor for a yearly exam. It was the first time she had a 3D mammogram. The doctors found of cluster of spots that ended up being cancerous.
"It's a scary thing to be told you have cancer," she said.
After going through radiation treatment and several surgeries, she has been able to come out on the other side of those treatments with no detection of cancer. She believes this was because it was caught early with newer technology.
"I was very lucky," she said.
'Crusader' for checkups
Drenna Barnes, who is also in her 70s, has gone through three cancer diagnoses. Two of those were breast cancer. She had to get a lumpectomy in 1999 when she was living in Alaska. In 2010, she was diagnosed with leukemia and went through treatment to remove the cancer.
Then, in 2016, she said she thought she had a really bad summer cold because she couldn’t stop coughing. At one of her 6-month checkups with her doctor, she mentioned the cough and went through a routine breast exam.
Her doctor noticed a rash on her chest.
“That’s when she said, 'I don’t think this looks right,'” Barnes recalled. “This is why I’m a crusader for going to the doctor.”
She said that years ago she had previous doctors notice a sharp indentation under her arm. They told her they were stitches from a previous procedure. She learned in 2016 that it was cancer. She had to go through chemotherapy, and eventually, a mastectomy in December 2016. She, too, is now cancer free.
"If I was getting an Oscar right now, I would have to thank all my doctors and all my nurses" she said.
Beating the odds
Fields is one of the longest breast-cancer survivors in the Lowcountry. She was a nurse at the Charleston County Hospital when she was diagnosed in 1974. She said she would always comfort patients and give them advice when they got news about about breast cancer.
"I got to use some of the same advice," she said.
She remembers her two children crying when she told them about her diagnosis in 1974 and telling them not to worry because she believed she would be here a long time. She also remembers crying herself after her mastectomy when she realized she couldn't lift her arm to comb her hair.
But she said she stayed positive. At the time, she said she figured 10 years would be long enough to see her children finish growing up. She is thankful that today she has lived long enough to see her four grandchildren and 12 great-grandchildren.
She also wants women and men to have more awareness about the disease and trust in their doctor if they get a diagnosis.
“Everybody should be knowledgeable now," she said. "It's not like it was back then."