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COVER STORy: BREAST CANCER SCREENING
“I know a lot of women whose breast cancer was detected early. … who are getting a chance to see their kids grow up and are living a full and great life.” Monique James
early testing saves breast cancer patient’s life By Sheshe Giddens
When new guidelines for mammography were announced last fall, they took Monique James’ breath away. she is living proof that screening before age 50 and breast self-examination save lives.
her daughter’s kindergarten graduation, her son’s first art contest, these are events James would have missed had she and her doctors followed the new screening guidelines. Fortunately, the 45-yearold breast cancer survivor doesn’t have to worry about whatifs. Diagnosed at 38, early detection saved her life.
“This recommendation made me angry because I know a lot of women whose breast cancer was detected early — before age 50 — who are getting a chance to see their kids grow up and are living a full and great life,” James says.
The U.S. Preventive Services Task Force’s recommendation to only conduct routine breast cancer screenings in women ages 50–74 sparked controversy among physicians, breast cancer advocates and patients across the nation. The task force also advised against health care providers teaching women to perform breast self-examinations. But for women like James, beginning breast cancer screening at 50 would have been too late.
“Since the onset of annual screening mammography in the 1990s, the mortality rate from breast cancer, which had been unchanged for the preceding 50 years, has decreased by 30 percent,” says Dr. Luz Venta, medical director of the Methodist Breast Center.
National cancer organizations respond
Despite the task force’s recommendation, the Methodist Breast Center, National Cancer Institute and American Cancer Society all recommend women receive routine mammograms starting at age 40 and earlier if there is a family history of breast cancer.
“I recommend a baseline mammogram at age 35 followed by annual mammograms starting at age 40,” says Dr. Eric Haufrect, James’ obstetrician/gynecologist. “Screening can begin even earlier in high-risk circumstances such as in the presence of positive genetic testing.”
He also recommends breast self-exam to his patients. “They don’t need to know what it is that they are feeling. They simply should be familiar enough with their breasts so that they are more likely to feel a change in their self-exam,” he says.
early testing
The Methodist Breast Center is recognized as a Breast imaging Center of excellence by the American College of Radiology and is accredited by the National Accreditation Program for Breast Centers.
James’ story
Haufrect insisted James have a baseline mammogram at 35. So when she detected a lump a year later, the radiologist was able to make a comparison. After a biopsy and excision, it was determined that the tumor was fibroadenoma, a benign tumor of the breast most commonly found in women during their childbearing years.
Because of the fibroadenoma, James was scheduled for a routine mammogram the following year. In September, an MRI revealed cells that looked abnormal, but they proved to be noncancerous. Five months later, that all changed.
“I was so grateful to Dr. Venta for taking the time to really explain what she saw on my ultrasound,” says James, who was diagnosed and treated at the Methodist Breast Center. “She showed how one of the cells went from spherical in shape to not being very well defined. She told it me it looked like cancer and insisted that I have it biopsied that same day.”
Two days later, it was confirmed that she had breast cancer. James later learned that the cancer had spread to one of her lymph nodes.
James was fortunate. her cancer was detected early because of screenings and her ability to recognize changes in her breast.
BREAST CANCER DETECTION METHODS
Screening mammogram Used for routine screenings, compression is used to minimize X-ray radiation exposure.
Diagnostic mammogram Used to investigate changes in the breasts and to clarify results of a screening mammogram.
Breast ultrasound Determines if a lump or mass in the breast is filled with fluid or is solid tissue, which requires a biopsy.
Breast MRI Highly sensitive test used in suspected cases of breast cancer and in dense breasts.
MRI-guided biopsy
Stereotactic biopsy
Ultrasound biopsy MRI scan is used to guide a fine biopsy needle to the suspicious site to collect tissue samples.
A mammogram (X-ray) view used to guide a core biopsy needle to the suspicious site to collect tissue samples.
Ultrasound view used to guide a fine biopsy needle to the suspicious site. Used if the lesion is too small to be felt.
Talk with your doctor
About 500 patients are diagnosed or treated with breast cancer each year at the Methodist Breast Center; about 21 percent of those are under age 50. “Nearly 50 percent of our patients with breast cancer last year fell outside the panel’s guidelines: younger than 50 years old and older than 75. This is a significant proportion of the women with breast cancer in our center,” Venta says.
Although mammography continues to be the gold standard in breast cancer detection, the Methodist Breast Center utilizes additional state-of-the-art technology and services to aid in the diagnosis and treatment of breast cancer (see page 8).
Patients should discuss any concerns and family history with their physician to determine when they should begin routine breast cancer screening. It is essential to know your family history and be aware of any changes in your breasts.
After James’ breast cancer diagnosis, she grew concerned about whether she had a genetic predisposition toward developing breast cancer that might also affect her younger sister or her children. She had genetic testing for the BRCA1 or BRCA2 mutation, which, if present, highly increases a woman’s chance of developing breast and ovarian cancer. Fortunately for the rest of her family, the test came back negative. Now, James is focused on her family and her business.
As the owner of two Beauty First franchises in Houston, she comes in contact with women from all walks of life, including cancer survivors. She understands better than most the toll the disease and treatment can have on a woman’s body and self-esteem. She herself used one of the product lines her store carries that encourages hair growth after she lost her hair during chemotherapy.
So when women dealing with cancer visit her store — searching for a tiny bit of normalcy in the form of hair and beauty products — they can relate to James because she has been there — and survived. n
For more information about the Methodist Breast Center, call 713-441-PINK (7465).
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MAMMogRAM PARTies
There’s a little-known after-hours spot tucked away in Upper Kirby, where a group of friends gather for pampering with relaxing spa treatments and refreshments after a long day at work. No, this isn’t an after-hours spa or a fresh twist on happy hour; it’s a mammogram party.
Available at the Methodist Breast Imaging Center since last fall, this fun and unique concept provides a supportive atmosphere that eases the anxiety associated with having a mammogram.
“The idea behind these parties is to take the fear out of getting a mammogram and to prevent others from falling behind in getting their routine screenings,” says Laura Zeisig, manager of the Methodist Breast Imaging Center at Upper Kirby. “A lot of time a woman’s schedule is too busy. This invites women to come after hours and get their screening mammogram without interrupting their daily schedule.”
Mammogram parties are available to groups of six or more women who are due for their annual screening. The party also includes complimentary professional chair massages by Chrysalis, refreshments, education and giveaways.
To host a party, call the Methodist Breast Imaging Center at 713-441-9740. Simply provide the name and contact information for each of your guests. The staff will assist everyone in obtaining the required doctor’s orders for the mammograms and will follow up with each guest.
“We ease a lot of anxiety for patients coming in for a mammogram, ultrasound or biopsy. They can have the procedure, talk to their physician, ask questions and get their results all during the same visit,” she says.
Physicians at the center also facilitate referrals, if needed.
“This setting and personal, one-on-one care between physician and patient really sets us apart from other facilities that don’t provide this type of access,” she says. n
