What
I wish I’d known about early
detection:
• I was at
risk. I didn't think it could happen to me, because I was
so healthy and did everything I knew to reduce my risk. I
was a health and fitness professional for 23 years at the
time, doing everything"right". If you are a woman and you
are getting older, you are at risk. Seventy-five percent of
the time there are
no identifiable risk factors!
• That SBE (self breast exam) and CBE (clinical breast
exam with your doctor examining) are even more vital for a
woman with dense breasts. Without a mass to examine, or
other identified concern, routine ultrasound or other
imaging is not conducted.
• Regular, annual mammograms are vital for detecting
small changes that might indicate tumor growth (like
calcifications in unusual shapes and sizes). Avoid skipping
years or changing facilities without bringing your prior
films.
I skipped a few years before my diagnosis and changed
facilities. My four large tumors could not be seen on a
mammogram, but the calcifications that indicated changes,
could be. After the changes were noted and a follow-up exam
in 6 months was recommended, I went home and did a self
breast exam, which led to my feeling something suspicious.
I went to my physician who didn't feel anything but told me
I could see a surgeon if I was concerned. Because he wasn't
concerned, I decided to wait until my follow-up visit. At
my follow-up visit, I made sure they knew I had an area of
concern, which then led to further imaging. An ultrasound
was performed on that suspicious area and a cancer was
found. Once diagnosed, an MRI was ordered and found three
more tumors.
I could have seen a surgeon when my physician mentioned it,
but I overrode my intuition and thought that if he wasn't
concerned, I shouldn't be. This is where we should trust
our intuition if something doesn't feel right. It's hard to
know what waiting might have done in terms of tumor growth,
but at least I went for the follow-up appointment. I almost
left on that next appointment, not knowing I had cancer,
when a technologist told me I could go home after my
mammogram, and that everything was OK. I told her I was
there for a diagnostic mammogram and I had paid for it,
when she replied they had taken it off the bill already. I
paused and thought a minute, then responded, "But I have a
lump." She responded, somewhat surprised, and said, "Oh?
Where?" After I showed her, she immediately took me back
for ultrasound. Many women say they would have gone home
without saying any more. I was unsure as to whether they
had addressed my lump, and was confused. Thank goodness I
spoke up. This is an example of why it is so important to
partner with our providers, by making sure communication is
clear on both sides.
• Film mammography sensitivity is only 30-55% for
women with dense breasts. Digital mammography takes it up
to 70% in a best case scenario (quality equipment,
operator, and interpreting radiologist), but that still
leaves 30% or greater where cancers can be missed (in women
with dense breasts).
• Ultrasound has proven to increase the number of
cancers detected by 67-100% in studies at single
institutions. In addition, small invasive cancers have been
found with this technology, usually before the cancer has
spread to the lymph nodes. But remember, in most centers
you must have an identified area of concern before
ultrasound would be done; hence the need for SBE, CBE, and
RAM (regular, annual mammograms), to identify areas of
concern so further imaging can be done (often with
ultrasound or MRI).
For more information and a Q & A about breast density,
click on breast cancer facts to the left
or purchase my new book, "101 Things You Should Know
About Breast Cancer" here.
I
devised acronyms to help you remember to take action
with
SCRAM
exams© and to be FEISTY© with your actions!!
SCRAM exams©
S
self-breast exam,
monthly
C
clinical exam by
your doctor, yearly
RAM
regular, annual
mammograms after 40-don't skip a year
And
if you have a lump, or other identified concern,
be
FEISTY© with
your actions.
F
follow-up and
E
evaluate
I imaging
(further imaging)
S
surgeon (with a
breast surgeon when possible)
T
trust…
Y
YOUR
intuition!
A special
thanks to Wendie Berg, MD, PhD, FACR, Breast Imaging
Consultant and Study Chair for the American
College of Radiology Imaging Network (ACRIN) Protocol
on Screening Breast Ultrasound, for reviewing the
material presented for content and
accuracy
©2006-2010 Priorities
Simplified, LLC All rights reserved
