Breast Cancer Awareness Month: Insider's View

Linda Brogan (Medical Transcriptionist)

Tell us what happened.

It was June 1, 2015. RadNet had given me the green light to work remotely when I needed to care for my mom, so I was living in Resaca, Georgia. I went to the local hospital for my annual screening, and I brought my priors from RadNet's Advanced Radiology with me. (I’m a proud Baltimore native. Go O's!) As soon as the radiologist in Georgia, Dr. Courtney Perez, saw my priors, she wanted to meet me. She used to work at Advanced in Maryland! I'm a medical transcriptionist for RadNet, and I had transcribed her reports there. The chances of crossing paths with a RadNet radiologist in this tiny town—it was incredible.

I had family history—cousins, an aunt, and my mom—and dense breasts, plus some fibroadenomas in the past. For those reasons, all of my mammo screenings were ordered as diagnostic exams. Dr. Perez found a new cluster of micro-calcifications, very deep, and wanted to biopsy. The results showed a 0.8 centimeter DCIS (ductal carcinoma in situ).

That’s less than a third of an inch!

I owe my life to those radiologists. It’s a miracle mine was caught at that size, and with dense breasts. That’s why I always tell people—get your annual screening. And bring your priors! They have to be available for the radiologists to use for comparison, so they can detect any changes.

What happened next?

I went to a breast surgeon immediately, and we agreed on a plan. However, when the second pathology report came back, I took a close look at it. I was staged 0 because it was DCIS, but the tumor was grade 3, and markers were triple positive—PR positive and ER positive (which are hormone receptors), as well as HER2 positive. Through my research I found that HER2 positive cancers are aggressive and don’t respond well to radiation therapy. For these reasons, I wanted to alter our plan and have a double mastectomy instead. With significant family history and lumps since I was 23, I felt this was the right course. The breast surgeon heard my concerns, and we went with the bi-lateral mastectomy. He said I was one of the most informed patients he’d ever seen, which was due to my work at RadNet. Tell your radiologist you have questions; that’s why they’re there.

It was important that your clinicians had the whole picture

We trust our doctors, but every patient is different, every background is different, every medical problem is different. We’re all individuals. That’s what I love about working at RadNet—we treat patients that way.

What would you say to women who are procrastinating about screening?

My mammogram saved me from having to have chemotherapy. It saved me from having to worry every year—is it back? A screening doesn’t even hurt as much as going to the dentist. There’s nothing to fear. You have to look at it like you’re doing it not just for yourself, but also for your loved ones, your family. It’s so easy to do!

Donna Marin (Director of Scheduling Service)

The key to early detection for you was a breast self-exam, yes?

Yes. In June of 2014, I came home from work and felt something funny. I went to work the next day and told my boss, who immediately sent me to Dr. Sing at a RadNet center. I had a breast ultrasound, and RadNet had all my prior mammography exams for comparison. Then I had a biopsy—all in the same day. I found out the next day that I had invasive ductal carcinoma.

It sounds like a whirlwind.

I moved through the system very quickly, and yes, I saw a surgeon the very next day. In terms of the emotions catching up, something just came over me. I just knew I was going to beat it. I even shaved my own head! I had a great support team at work and especially at home, and I also knew that if I fell apart, then they’d fall apart. I had a lot of staff reporting to me; I've been working at RadNet for 24 years. I was very forthcoming and vocal with everyone about what was happening. This is the work we’re in, after all. Goodness knows I wish it had never happened, but at the same time I kind of embraced it. That was the best way for me to keep going forward.

Had you been having annual mammograms?

Absolutely. I found the lump in June, and I had just had a screening in April. But you have to understand that with dense breasts—and mine were extremely dense—it’s like finding a snowball in a snowstorm. It just wasn’t detectable that way. But I felt it. I had asked my GYN years before how one could distinguish a suspicious lump from normal ones. Well, I knew. It was like a sharp rock. So breast self-exams are definitely part of the self-care we need to do.

What happened after your diagnosis?

I found out I would need a mastectomy and chemotherapy. I chose to have a bi-lateral mastectomy—I wasn’t going to wait around for cancer to show up in the other breast—and that was in August of that year. Chemo started in September and went on for 12 weeks. A few months after that, I had reconstruction, and then a second reconstruction. I lost all my hair, but now I have long hair, and I’m six years out and doing well.

What was your reaction to the chemotherapy?

In my case, I was exhausted, especially by the end of it. I didn’t get sick exactly, just really tired, and I did have “chemo brain”—that’s real. But the important thing is that everyone is different. Some people do get sick. Some people recover quickly, and some don’t. Everyone has their own situation with cancer, and their own feelings. We should never assume that what happened for one person will be the same for another person. Every individual body handles it in a unique way.

What if someone says—“well, yours wasn’t caught by screening?”

I’d say, “Are you kidding me?” Anyone who knows the aftermath—losing your hair, losing your eyebrows, not being able to sleep, sleeping too much, sores in your mouth—knows it’s horrific. A screening is maybe 15 minutes of discomfort—shorter than the pain of a sunburn—in exchange for a shot at early detection. That quick inconvenience is much better than what I’ve experienced. You have got to go get screening. I’m very firm about that.

Alaina McMann (Scheduler, East Call Center)

Was your cancer found through a screening mammogram?

I was 35, so it was too early for me to get annual screening mammograms. Cancer doesn’t discriminate. It doesn’t matter if you’re under 40, under 20, over 50, over 80, or what race or weight or height you are. It doesn’t discriminate. A lot of women think it can’t happen to them.

Then how was it detected?

I don’t know what made me wake up that morning and do a breast self-exam, but by the grace of God I was able to feel something that just wasn’t right. This was October 7, 2016, and I was getting ready for work. I felt a lump in my right breast, and working for RadNet, I knew what I was feeling and what to do. My doctors answered my messages right away, and when I got to work, we found a same-day appointment for a diagnostic mammogram and breast ultrasound at a RadNet center. Seven hours later, the radiologist was fairly certain it was breast cancer, so we scheduled a biopsy.

You were young. Did you have a family history?

No breast cancer in my family, but I did have Hodgkin’s lymphoma when I was 21, and that affected the game plan for treating the breast cancer. After the biopsy confirmed it—I was staged at 2B—we established that I would have a bi-lateral mastectomy. I had that, reconstruction, chemotherapy, proto radiation, and oral chemo.

Who drove the conversation on treatment?

I elected a double mastectomy because of my history, even though I had no cancer in my left breast. I’ve seen people get one breast removed and, even with a small chance, it comes back in the other one. The doctors went back and forth with me on it, but I felt—well, my body had chemotherapy in 2002 and radiation in 2003. Now I was facing both treatments again in 2016, and I didn’t want to risk a recurrence and make my body handle all that again in the future. The medicine has changed in the last few years, but at the time I wanted to go full force. I didn’t want it to come back. I had five months of chemo.

Talk about support—in terms of giving and receiving it.

I had survivors in my corner, two people in particular who had been through it—one was a RadNet employee. I laughed with her, cried with her, and asked her random questions at random times. I got to see what my chest was going to look like. She was the light for me. People who know me know that I am always willing to talk with anyone who gets in touch. It’s a broad spectrum with breast cancer though. People tend to think that an outcome that happened for one person will automatically happen for another person. It’s not like that at all. Every patient story is different.

What are your thoughts on screening?

I wish they could be done sooner, but if you’re too young, then know your body. There is no reason not to do a self-exam. Being a scheduler, I see it all the time—people whose last screening mammo was in 2013. You are procrastinating on saving your own life. Being asymptomatic means nothing. Cancer is silent. An annual screening has to be done like clockwork. It’s 10 or 20 minutes that could literally change your life. You could go from life to death without that test. I can’t stress enough how important it is.