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Format: 04/16/2014
Format: 04/16/2014


Pittsburgh Post-Gazette: Get a mammogram: NO EXCUSES

Tuesday, December 8th, 2009

By Jennifer Gill Kissel

I wanted to lose 10 pounds before my first mammogram. Not that the technicians would notice an extra slab of flab amid all the flesh they work with. I guess it was an excuse, which we women are experts at when it comes to mammograms. We are procrastinators, martyrs, scaredy-cats and scatterbrains, when convenient. We catch colds and the dog throws up. My friend Kathy has been saying for a year, "I really should make a mammogram appointment." We all say that. Our excuses are as ample as Dolly Parton's bosom.

A stranger named Colleen Reynolds shook me from my apathy. I interviewed Colleen two months ago for an article I wrote about breast cancer. Colleen's doctor found a tumor during her annual mammogram and ultrasound when she was 47. Now she is 49, and cancer free.

Although I had written many times about breast cancer awareness, I never got a mammogram. A friend, MaryAnn, died of breast cancer at age 39; but it was so fast and ugly that few of us processed it for what it was. I had no risk factors. Doing self-exams seemed like feeling for a grain of salt in a loaf of bread (or in my case, a biscuit). My midwife gave me a mammogram prescription last year when I turned 40, but the scrip expired in my wallet.

In October, after I interviewed Colleen for an article in which I encouraged other women to get mammograms, I felt like a hypocrite and had exhausted my supply of creative excuses, so I made my appointment.

If I had waited another month, this story (spoiler alert: it has a happy ending) might never have been written, because I would have been handed another excuse not to get my mammogram.

In November, the U.S. Preventive Services Task Force gave license to apathetic women like me to wait until age 50 for a first mammogram. Chairman Dr. Diana Petitti said, "We're not saying women shouldn't get screened. But we are recommending against routine screening." The group also advises women to consider false-positive results, radiation exposure, false reassurance and pain when thinking about mammograms.

Komen for the Cure (a national breast cancer advocacy and education organization), the American Cancer Society and other groups work hard to get women to stop making excuses. In 1982, when Komen was founded, the five-year survival rate for a woman diagnosed with early stage breast cancer was 74 percent. Today it's 98 percent, in part due to early screenings.

Some women use the excuse that they can't afford a mammogram. But Komen funds a mammogram voucher program for uninsured or underinsured women. The voucher covers the cost of a mammogram and other needed diagnostic tests (call 1-888-687-0505). If you feel a mammogram is a financial burden, you'll get a voucher.

Some worry about radiation exposure during mammograms. They should discuss options with their doctor, and at the very least do self-exams. Some women are turning to Digital Infrared Thermal Imaging, or thermography, in which technicians capture a digitized image of the breast on an infrared heat picture.

Too busy? I spent more time buying a celebratory bagel after my mammogram than I did at my appointment. Afraid it will hurt, you'll find out you have cancer, or you'll be embarrassed to be seen naked? You know the answers: Cancer hurts a lot more. Being seen in your coffin is also pretty awkward for everyone involved.

When I asked Colleen Reynolds' permission to use her name here, I told her she inspired me to get my mammogram and that I was awaiting biopsy results. She said she would pray for me. We talked about the new recommendations and worried that insurance companies will decide not to pay for screenings for women younger than 50.

"If I had waited until I was 50," Colleen said, "I would have been dead."

My mammogram didn't hurt. Instead, I marveled at how such a small amount of flesh could appear so bountiful through the magic of compression. Sort of like a push-up bra, but with a smashed-flat effect.

I left with a pink pen and the disappointing knowledge that I wasn't likely to be mistaken for a squashed Victoria's Secret lingerie model until next Columbus Day.

But three weeks later I was back, performing more breast acrobatics. A doctor wanted a diagnostic mammogram to better examine calcifications in my left breast. Then I was sitting with my robe loosely tied, feeling slightly vulnerable and listening to a doctor recommend a biopsy. "I don't think it's cancer," she said, but she didn't want to wait another year. The word cancer jolted me, because I expected her to use a euphemism, such as "I don't think it's anything to worry about."

I nodded and acted cool. A week later I was wandering through the stairwells at Allegheny General Hospital, realizing how thin the line is between being a person who does not have cancer and being one who does.

My biopsy was more of a disruption than a worry. My insurance company kept insisting I didn't need a referral. (I did.) I was thinking about getting the kids from school, and impending deadlines, and whether my sore breast would interfere with my running regimen.

As I crossed through the doorway from the Allegheny General parking garage to the Cancer Center, which houses the Breast Care Center, I had a surreal moment when I imagined how a woman with cancer feels, crossing that portal linking a world where people simply live to a world where people fight to live.

The Breast Care Center staff are kind and wish everyone good luck. But in the waiting room, I felt like an imposter. A beautiful, tall woman with a cane looked like she had passed through the Cancer Center doors one too many times. A tired looking man gazed through me. I felt embarrassingly healthy.

My nurse, Barb (I think that was her name, but I was a bit distracted), made sure we were both clear into which breast the doctor would jab sharp objects. "You'll lay face down," she said, gesturing toward a cushioned table, "and place your breast in this hole." She pointed to a hole through which an oversized beach ball could easily pass. "Good thing that hole's really big," I noted, looking for a laugh. Barb smiled, but I think she was trained to withhold comment on the size of her patients' appendages.

Then I was on the table, seeking a comfortable position because I had to remain completely still through the photographs, needle insertion and tissue extraction.


Read more: http://www.post-gazette.com/pg/09340/1018515-109.stm#ixzz0Z7GkHbQq

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