AUSTIN, Texas — October is Breast Cancer Awareness Month. One in eight women will be diagnosed with breast cancer in their lifetime. This high percentage is why it is so crucial to educate each other on breast cancer risks, screening and treatments.
Health care workers with Ascension Seton say starting at age 40, women should get yearly mammograms. If you have a strong family history of breast cancer, you can talk to your doctor about potentially getting screened earlier. You should also do monthly self-exams at home and, if you feel a lump, you should call a doctor right away.
Kimmie Ellison, an advanced practice nurse for the Ascension Seton Cancer Care Collaborative Breast Clinic, was diagnosed with Stage 0 breast cancer in October 2020.
“I had my biopsy and then the radiologist called me and said it shows ductal carcinoma in situ,” Ellison told KVUE. “And I was, I was blown away. I mean, obviously, I know this could happen because I see it all the time at work. But when it's happening to you? Yeah, it was a real shock.”
She said even if you are questioning something with your body and don’t know if you should bring it up to your doctor or are nervous to ask your doctor about something, you should do it anyway.
“If you feel a mass, never ignore it. I would so much rather a patient come to me with a mass and have it be benign than wait six months and have it be something that's not benign," Ellison said.
Ellison’s cancer was very treatable since it was in one isolated spot on her breast, and she had multiple courses of treatment she could choose from. Twenty percent of breast cancer diagnoses are found at Stage 0, like what Ellison had, or Stage 1. These breast cancers have a 99% survivability rate, which shows the importance of early detection.
Ellison chose to get a double mastectomy to almost fully eliminate her chance of breast cancer in the future. She said the decision for treatment is one each woman must make according to what is best for them. First and foremost, you want to be cancer-free, but Ellison said you also have to choose what you are comfortable with.
“I went ahead and did a bilateral mastectomy to effectively erase my risk as much as I can. Not erase it, but reduce it to about 1% over the course of my entire lifetime. Average breast cancer risk is 12%, which is high," Ellison said. "I never have to go through mammograms again and not worry about whether or not my dense breast tissue was going to put me at further risk for developing cancer in the future."
As Ellison mentioned, she had dense breast tissue, which is a risk factor for breast cancer and also makes breast cancer harder to detect on mammograms. Once you start getting mammograms, 38 states, including Texas, require you to be notified by mail if you have dense breast tissue.
“If you do get that letter in the mail and it says you have heterogeneous dense breast tissue – which is about 40% of women – or extremely dense breast tissue, which is what I had – about 10% of women – talk to your health care provider,” Ellison said. “They can go over your risk factors with you, and then you and your health care provider together can make a decision about whether or not supplemental imaging is appropriate for you.”
In addition to family history and dense breast tissue, smoking and obesity are also two factors that increase your risk for breast cancer.
Ellison said there are a lot of great breast surgeons in Austin, but you should make sure to do your research and go to a fellowship-trained breast surgeon. She also encourages patients to advocate for themselves, educate themselves, ask questions and ask for help.
Breast cancer in the U.S.
According to BreastCancer.org:
- In 2021, an estimated 281,550 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S., along with 49,290 new cases of non-invasive (in situ) breast cancer
- About 2,650 new cases of invasive breast cancer are expected to be diagnosed in men in 2021. A man’s lifetime risk of breast cancer is about 1 in 833
- About 43,600 women in the U.S. are expected to die in 2021 from breast cancer. Death rates have been steady in women under 50 since 2007 but have continued to drop in women over 50. The overall death rate from breast cancer decreased by 1% per year from 2013 to 2018. These decreases are thought to be the result of treatment advances and earlier detection through screening
- For U.S. women, breast cancer death rates are higher than those for any other cancer besides lung cancer
- A woman’s risk of breast cancer nearly doubles if she has a first-degree relative (mother, sister or daughter) who has been diagnosed with breast cancer. However, less than 15% of women who get breast cancer have a family member diagnosed with it. About 85% of breast cancers occur in women who have no family history of breast cancer
Ellison's detection story
Ellison was diagnosed with Stage 0 breast cancer, the earliest form, in October 2020. She said she is the poster child for "early detection equals cure" and because of her work with breast cancer patients, she has an interesting perspective.
At 42 years old, she felt a mass in her right breast about a month after a routine screening mammogram which showed no abnormalities. She reached out to her doctor who ordered more advanced imaging since her screening mammogram demonstrated dense breast tissue, which is known to make breast cancer harder to detect. The mass appeared benign, and it was recommended that she repeat the imaging study in six months.
Months later, she repeated the study, only to find a new lesion in her left breast. A biopsy was done and Ellison was diagnosed with Stage 0 breast cancer.
Because of her role at the Ascension Seton Cancer Care Collaborative Breast Clinic, Ellison knew her options to treat her Stage 0 breast cancer:
- lumpectomy, a surgery that removes the abnormal cells and a little of the normal tissue near them, with radiation followed by hormone suppression
- a left breast mastectomy, a surgery that removes all the breast tissue, followed by hormone suppression
- or mastectomies of both breasts
Due to her dense breast tissue which increased her risk for future breast cancer, Ellison opted for bilateral mastectomies.
Today, she is cancer-free. She understands that her profession and education made it easy to advocate for herself throughout her breast cancer journey. However, this is not the case for many women in Central Texas.
Help with treatment costs
Recent reports show Texas is the most uninsured state in the nation, with about 18.4% of Texas residents with no health coverage. As this number continues to grow, it is essential that women and men have access to affordable breast care options and resources.
In Texas, women who make more money are more likely to get screened for breast cancer. In 2016, the Texas Department of State Health Services reported that 72% of women who made under $25,000 said they got a mammogram in the previous two years. That's compared to 77% of women who made between $25,000 and $49,999 and 85% of women who made $50,000 or more.
“Within Travis County, there are indigent funding options. There's also Breast Medicaid, which is a State-run program [that] provides really, really good care and ancillary services in the way of transportation to and from treatment. And so, that's another good source. And then there are also charity programs,” Ellison said.
Ascension Seton’s Breast Care Clinic at the Cancer Care Collaborative says it offers care to patients with a breast cancer diagnosis while also addressing the social determinants of health. Its program can:
- Diagnose and treat breast cancer
- Provide genetic testing and subsequent referrals if needed
- Determine eligibility for funding through community organizations
- Overcome transportation barriers
- Connect patients with resources and support groups
“We prioritize the health care of these women, and it's really empowering,” Ellison said. “These women are some of the bravest, most resilient women that I have encountered. I love my job, it's great. And after I was diagnosed, it just lit a fire underneath me. I want to get as many people diagnosed as early as I was and have them cancer-free and in the short amount of time that it took for me.”
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