Posted: March 2010
Physicians at Missouri Baptist Reaffirm Traditional Guidelines
If I’d had to wait until age 50 to have a mammogram, I’d be facing a very different scenario,” said Kirkwood mother Dana Kras, who was diagnosed with early stage breast cancer last November following a routine mammogram. Kras was 48.
One of four women diagnosed with breast cancer are under age 50, according to data collected at Missouri Baptist Medical Center over the past three years – a fact that has led physicians here to reaffirm that women ages 40 to 49 need annual mammograms.
WHAT MOBAP RADIOLOGISTS SAY.
“Under the current American Cancer Society screening guidelines, it is well documented that breast cancer deaths have dropped 30 percent in women of all ages,” said Geoffrey S. Hamill, MD, PhD, section chief of mammography.
“While there are no perfect tests in medicine, screening mammography offers women the best chance of detecting early breast cancer,” said Dr. Hamill. “We urge women to get yearly mammograms starting at age 40.”
WHAT’S AT STAKE FOR WOMEN.
Following her digital mammogram, Kras was told they saw some micro-calcifications. “They wanted to take a closer look,” remembered Kras.
Calcifications are tiny mineral deposits within the breast tissue that look like small white spots on breast images. They may or may not be caused by cancer. There are two types of calcifications – macro- or larger calcium deposits, which most likely are caused by aging of the breast arteries, old injuries, or inflammation. These deposits are related to non-cancerous conditions and do not require a biopsy. Macro-calcifications are found in about half of women over 50, and in about 1 of 10 women under 50.
Micro-calcifications, which are very small and can be detected by a digital mammogram, usually do not mean that cancer is present. If the calcifications look suspicious for cancer, however, a biopsy is performed.
“A biopsy confirmed that I had breast cancer,” recalled Kras. “I was in shock. I received the call just before picking up my eight-year-old daughter. Emotionally, I quickly went downhill after sharing the news with family and close friends. It never crossed my mind that I’d have breast cancer – that it would be me. After all, I felt good. Nothing was different. There wasn’t a lump I could see or feel.”
Kras said Amy Eberhardt, breast health navigator at Missouri Baptist’s Multidisciplinary Breast Clinic, met with her the next day. “She was so sweet to me. My husband was right there with me. I call him my ‘rock.’ When you’re first diagnosed with breast cancer, it’s a lot to take in at once. Amy explained all of my options so I could understand them. This provided a lot of comfort to both of us.”
Kras and her husband then met with breast surgeon Paul Yazdi, MD, director of the Multidisciplinary Breast Clinic. “Dr. Yazdi showed us my mammogram on his computer. Digital technology is very amazing. If I hadn’t gotten the digital mammogram, it could have been another year before they would have detected it. It may have grown to the point where I could see and feel it,” said Kras.
“Dr. Yazdi explained I was in ‘Stage 0.’ I never knew there was a ‘Stage 0.’ It’s the earliest possible stage to detect. I was relieved that the breast cancer hadn’t spread to my lymph nodes.”
“I want to live to see my daughter grow up,” said Kras. “I’m okay with it because I have a very strong faith. I knew I had to take it a day at a time. And that’s what I did each of my 33 days of radiation – I just thought about getting through that day. Now, I’m taking a preventive medication for five years.”
“I totally disagree with the guidelines issued by the Task Force last year,” Kras said emphatically. “I think that women should be able to get a mammogram at age 40. Doctors and researchers know so much, but they don’t know it all. They still don’t know why breast cancer develops.”
HER MESSAGE TO OTHER WOMEN.
“I didn’t drink or smoke. I considered myself a ‘thoroughbred.’ Annually, I got a physical exam, watched my weight and exercised – all the stars were aligning so well,” she said. “Women need their baseline and annual mammograms, following the American Cancer Society’s guidelines. Do it for your sake – and for the sake of your daughters and their daughters.”
Geoffrey S. Hamill, MD, PhD, a board-certified diagnostic radiologist, is Section Chief of Mammography at Missouri Baptist Medical Center. He received his medical degree from State University of New York (SUNY-Buffalo), completed a surgical internship at Swedish Hospital, Seattle, a residency in radiology at the University of Washington, Seattle, and a fellowship in pediatric radiology at Children’s Hospital and Medical Center, Seattle.
G. Paul Yazdi, MD, FACS, a board-certified breast surgeon, is Surgical Director, Multidisciplinary Breast Clinic at Missouri Baptist Medical Center. He received his medical degree from the University of Missouri-Kansas City School of Medicine, and completed his internship, surgical residency and fellowships in general surgery at the University of Missouri Hospital and Clinics. He did a fellowship in surgical oncology at Ellis Fischel Cancer Center.
These recommendations include:
- Yearly mammograms starting at age 40 and continuing for as long as a woman is in good health.
- Clinical breast exam by your physician about every three years for women in their 20s and 30s and every year for women 40 and over.
- Breast self-exams starting as a woman enters her 20s. Women should know how their breasts normally look and feel and report any change promptly to their healthcare provider.