By Mary O’KEEFE

Although October has been designated as Breast Cancer Awareness Month, the fact is every month, week and day women, and men, should be aware of breast cancer and proactive in protecting their health.

CVW have heard stories from a number of women who have had mammograms and ultrasounds during their annual checkups and were told a “spot” was on one of their breasts … or are simply told that something “unusual” was seen. In some cases these women were immediately given an appointment so further research could be done but others who were told it wasn’t an issue in a few months found it was cancer and  had spread. 

There are extreme stories like these (and every type of story in-between) and it is important for women and men to know who feel there is something “not right” that they have the power to move forward. 

Dr. Emma Koesters, MD, plastic and breast reconstructive surgeon with Keck Medicine of USC, said it is important to find a breast surgeon or primary care physician who will listen to a person’s concerns. 

“No imaging is perfect so sometimes we need different modalities, sometimes we need to follow up with ultrasound and sometimes you need an MRI,” she said. “If the breasts are really dense it’s hard to see things that can be concerning. I think you have to have a provider that you can have an open dialogue with and who is willing to take further steps to make sure something is there or something is not there.”

Sometimes patients feel they don’t have an option to request another doctor once one has been assigned to them or they are hesitant to insist that follow up tests be done. 

“They feel guilty about [looking for another doctor] or they just don’t know there’s other [doctors] out there,” she added. “You can always go see someone else and get a second opinion.”

Sometimes getting a second opinion is a problem because decisions from insurance companies take so long to come. Some of the women CVW has spoken with shared their stories of insurance roadblocks. This is a nationwide issue. In an article from Cancer Care titled “The Health Insurance Maze: How Cancer Patients Get Lost in the Red Tape of Utilization Management,” a study concluded that 85% of those surveyed faced prior authorization for cancer treatment, often multiple times. And 29% reported diagnosis delays and 40% reported treatment delays due to needed authorizations that were slow in coming. 

These issues may increase as changes come to the Affordable Care Act in 2027, including an estimated 15% increase in monthly premiums, and others being dropped from health care insurance completely. 

It is important, though, that people are their own advocate for their health, even if that means spending hours on the phone with insurance companies. 

It is also important to be proactive by having mammograms and ultrasounds when required. In many cases those with dense breasts are recommended to get both a mammogram and ultrasound. People can find out if they have dense breasts after getting their mammogram. It will describe on the report the breast as “dense.” 

But even if someone does not have dense breasts more exploration might be needed.

“There might be a certain area where the [patient] needs a follow up and a different view because each of these techniques is sort of better at looking at things a certain way. MRIs are really advanced imaging and can show you a lot of things, but there are some things that you won’t see on an MRI that you’ll see on a simple mammogram,” Koesters said. 

She added these different techniques are complementary to each other and work especially well with dense breasts. The bottom line is to make sure to get a breast examination on a regular basis, depending on what your doctor advises. 

“I think sometimes people fall in the trap of ‘I don’t have any family history of breast cancer. I don’t have any major risk factors so I’m not the one that is at the most risk’ and in truth the majority of women who get a diagnosis of breast cancer do not have family history, genetic mutation or something that puts them at super high risk,” she said. “It really can be anyone. Getting your mammogram is the most helpful thing you can do for yourself.”