Breast Cancer Awareness Month Kicks Off

Getting a mammogram isn't the first thing women look forward to when they turn 40. But according to Maj. Andy Fong of Blanchfield Army Community Hospital, they are an essential part of reducing deaths from breast cancer.

"The reason why it's important to get a mammogram is to try to reduce the mortality from breast cancer - that's the main reason," Fong said. "When you think 'what does a mammogram do?' you're looking for cancer. So if there's a way to reduce the mortality associated with that, then we're doing well, and mammography has been proven to reduce mortality."

Mammography is the only proven method to reduce the chances of dying of cancer, Fong emphasized. But many women are still lax in getting screened regularly.

"A lot of women I think are reluctant to come get a mammogram because they're so worried about if they do have cancer. It's an automatic very poor prognosis," Fong said. "However, things have changed so much in our ability to detect things so early. That's really changed how patients are treated and their overall mortality."

LaVene Lohrbach, the lead mammography tech at BACH, explained that mammography technology is improving on almost a daily basis. The introduction of digital mammography allows radiologists to see things in greater detail than with analogue pictures.

"[It] can pick up things that analog imaging may have a little bit more difficulty picking up," Lohrbach said. "With that, we'll be able to detect earlier cancers."

Lohrbach added that out of 5,500 patients a year, only about 25-35 cases of breast cancer were identified per year at BACH.

The advances in technology has also allowed for screenings on women much younger than 40.
"If a patient has a significant family history of breast cancer, which would be a mother, sister or daughter, they can start their routine screenings up to 10 years before that relative was diagnosed," Lohrbach said.

That means if a mother is diagnosed with breast cancer at 35, her daughters should begin getting annual screenings as early as 25.

"We've had lots of success stories where we picked up very early cancers, and very treatable and potentially curable," Fong said.

But there are still some cases of breast cancer that go unnoticed by mammograms.

Lohrbach said it's important that women have annual clinical breast exams as well as perform monthly self breast exams because up to 10 percent of breast cancers are felt, but not seen.

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"There are three components to breast health," Lohrbach said. "One is a clinical breast exam with the primary care provider doing a physical examine on the breast once a year. [Second,] the patient should do monthly self breast exams, and also do your mammogram once a year. All three of those, if done in the time frame they're supposed to be done, then you're detecting breast cancer at its earliest stage, when it's easiest to be cured."

For one surviving spouse, pains in her breast lead to finding a lump - the first sign of breast cancer, despite annual mammograms.

"I was relying solely on my annual mammograms, so I was not doing the monthly check ups," said Madeline Haller, retired principal. But when her breast began to hurt, she checked herself and found a lump.

Haller was a month short of her yearly exam, but decided to mention the lump to a doctor friend in her Bible study, who told her to make an appointment as soon as possible.

"I went in and they first did an ultrasound and that was inconclusive, and then they did a needle biopsy - where they take a needle and stick it in a lump and try to take out a plug of tissue and then examine that under a microscope - and that was inconclusive," Haller said.

"If they can't really detect either one of those things, the next thing to do is actually go in and have the lump removed, which is the best thing really," she added. "The others things can be not as accurate as just going in and taking the lump out and letting the pathologist do his thing."
Lohrbach said when the lump is found through mammography, the patient will be called in for more pictures before being sent to biopsy.

Haller said when her results came back positive she couldn't believe it because she'd always considered herself to be in the low risk category.

"I felt like I'd kept all the rules," Haller said. "You know, we kind of make a pact with life where you eat healthy, you exercise regularly, you're not overweight, you don't smoke, you don't drink excessively or anything, so you feel like you keep all the rules and then you still get sick, you still get it. It doesn't seem to have a rhyme or reason about who it strikes."

She said the only thing she learned to explain her condition was when her oncologist at Vanderbilt told her that excessive stress can lead to cancer later in life.

"He said it is not unusual for someone to go through something stressful - i.e. my husband being killed in the military - and 15 to 20 years later end up with cancer," she said.

Haller's husband died in the 1985 Gander crash. In November of 2000, she was diagnosed with breast cancer.

"That's what I mean, you can't just think that if you keep all the rules you won't get it," she said. "Some of that stress - it's not due to something you've caused. It's just the way life goes."

Lohrbach added that women over 40 or with a family history of breast cancer, who don't feel lumps or exhibit any other symptoms, can schedule a screening mammogram without seeing their primary care provider first. Women with symptoms should first see their provider for a clinical exam to go along with the mammogram.