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There were three particularly important women diagnosed with breast cancer in the 1970s: Betty Ford, Happy Rockefeller and my mom.

One evening in the fall semester of my junior year in college, I was called to the pay phone positioned in the entranceway of my dorm. It was my dad. He explained that mom was in the hospital.

She had gone in that morning to have a breast biopsy, but when the doctors discovered cancer, they proceeded with a radical mastectomy. I wasn't the only one caught off guard. When my mom woke up from surgery, she heard the news for the first time, too.

Over Christmas break, mom was still recuperating. She and dad drove me back to college in late January. Walking across campus to my dorm, she linked her arm through mine the way older people sometimes do to steady themselves. It was strange to think of my mom as vulnerable and depending on me instead of the other way around.

When I returned home that summer, I heard her full story. She had felt a lump in her breast and brought it to her doctor's attention. He dismissed it as inconsequential. When she went back a second time, he still didn't pay attention. Finally, she marched into his office with the ultimatum the he either do something about the lump in her breast or she would find another doctor.

That post-surgery summer she was angry. She had entered the hospital expecting a biopsy and came out minus one breast and her pectoral muscles. She was grieving the loss of a breast as well as the increased disfigurement of a radical mastectomy. She was frustrated by the loss of her upper body strength.

I remember so clearly sitting on her bed one summer day after she had been fitted for her first prosthetic breast. I watched her try on clothes, adjusting herself, assessing each outfit in the mirror to see which she could still wear comfortably.

"I've never considered myself a feminist," she said, "but I have to admit they make some good points."

She talked about the use of breasts in advertising. How the cut of women's clothing was intended to reveal beautiful, symmetric, unscarred breasts. She and my father used to get dressed up on occasion and attend dinner dances with their friends, switching dance partners through the evening. But now, she said, she sensed men in their social circle felt uncomfortable dancing with her. Did people look at her and wonder which breast she had lost?

Of course she was grateful to be alive. Everyone was grateful she was alive. But cancer is much more complicated than surviving. Based on what my mom shared with me, she never again looked at life exactly the same way. There was the fear of reoccurrence and the increased vigilance of looking for signs. There were financial considerations, fortunately, none devastating for her.

There were decisions to be made about post-surgery care. In her case, this meant a second mastectomy due to the high risk of the cancer spreading to the other breast. There were decisions about reconstructive surgery.

There were other complicated personal decisions, as well. Should she dip into hard-earned personal savings and do more things for herself, just for the pleasure of it? Would it help my sister and me if she was tested for the "cancer gene," so we might know what to expect? Should she keep her story private, or be more open and public about it?

One decision my mom made was to get involved in education and prevention efforts. She volunteered with the American Cancer Society and found her niche giving presentations to middle and high school students on breast and testicular self-examinations.

She also developed a close mentorship relationship with my cousin who, in her 30s, was diagnosed with a very aggressive form of breast cancer. Mom's bookshelf filled with medical and self-help books about breast cancer, and testimonials such as Betty Rollins' inspirational, "First You Cry."

Mom started to do more things that gave her pleasure - things that money or time or other commitments had kept her from doing previously. She and my father took some trips together. She visited extended family in Sweden. She read history and biographies and kept up on current events.

A phone call I received in early September 1998 was very different from the one in 1977. Again, the news was bad: Mom's cancer had returned. But unlike the 1970s, she had a physician who listened to her. She had more information to work with. There were more treatment options. And people didn't have to whisper the "C" word anymore, at least not as often.

"Cancer looks very different to me now than it did in my 40s," she told me that morning.

Mom was right. A lot had changed in the diagnosis, treatment and public recognition of breast cancer since 1977. We can all be grateful for that. But surviving cancer is still complicated.

• Carol Prentice is caught in the middle of life, work and family in Juneau.

To read this and other articles celebrating Breast Cancer Awareness Month,visit juneauempire.com/breast_cancer