I know it is October in my town because all the stores and decorations around town have turned bright pink. It seemed like overnight pink covered everything, even before the leaves created that red, yellow, and orange blanket of autumn. Breast Cancer Awareness Month is upon us.
I reflected while driving through the downtown that breast cancer has come a long way, but still has a long way to go. I remember being a child and hearing that a female had breast cancer. The patient and family were given a death sentence, with a prolonged battle to fight and low chance of beating the cancer. Today, we have many people to thank for the knowledge gained and advancements in care, the first being the woman who stood up and stated that we need funding for research, because too many of us are fighting this fight. This funding provided money for the research on ways to attack the different types of breast cancer. Now we have multiple cell receptor markers, and the results direct target treatment. Secondly, we can thank the providers before us, who supported patients and family in the past.
Today we as providers push for early detection with our patients. Some patients are asking us for early detection, and then others require us to do major talking in their appointments to encourage them to screen. A few of my patients want to impart to us osteopathic physicians some reminders concerning breast cancer.
Ms. G was a 60-year-old woman who had worked in hospital administration for years. She had always gotten her yearly mammograms. Her appointment came up; she was busy and almost missed the appointment due to work. She kept the appointment, not expecting anything. Then results came back with a possible suspicious spot, prompting a diagnostic spot mammogram and ultrasound. Both came back suspicious. A biopsy was performed and was found to be cancerous. Fortunately for her it was small and receptor positive. A year later, she is cancer free. Her recommendation is to develop a good relationship with your radiologist and surgeons for early, fast, and smooth patient care. Her second recommendation is to keep up with preventive visits.
Ms. A is a 55-year-old nurse anesthetist who has yearly mammograms. One to two months after her mammogram, she noticed skin change over the nipple--it was flaky and white for about 2 weeks, and she had some clear nipple discharge. This concerned her, and she sought testing for it. The finding came back as intraductal breast cancer. She has finished treatment and is a two-year survivor. She wants to impart that breast cancer is not just masses in the tissue, which we focus on with mammograms. We also need to pay attention and have education about intraductal carcinoma. These cancers do not usually occur as masses on mammogram and can be missed if the signs are not connected.
The last patient is Ms. N. She was a breast cancer patient who fought the battle hard. She had breast cancer initially 15 years ago. She was a five-year survivor when she found out it had returned. She got more treatment and radiation, and everyone thought she had finally kicked it. She went back to work as a nurse, but dealt daily with limitations: scar tissue and muscle atrophy in her arm from surgery and radiation. She was the best at spreading smiles and laughter to colleagues, patients, and physicians. Working long hours and taking care of grumpy patients and providers did not diminish her joy. Her personality was infectious, which always countered her struggles. Then came the shocking news of breast cancer returning for the third time. She fought this as well, but it would not let go, and she lost the battle on earth. The lesion she imparted to everyone was that your attitude can change your day, and to spread cheer and joy despite the limitations of life.
Unfortunately, breast cancer still affects everyone, because either ourselves, a family member, a friend, or a coworker has been diagnosed with it. As physicians our role is three-fold. First is to provide patient and community education concerning screening tests and encourage order completion. Second, it is to provide support and encouragement as well as aiding rapidly getting patients to specialists when their tests come back with suspicious lesions. Lastly, encourage and participate in research and events that support breast cancer research funding.
