By Rae MillerNothing makes time stand still like finding a lump in your breast.
Even though you're frozen, your fingers are still pushing, prodding, palpating.
But you're young. You're busy. It's probably nothing you tell yourself.
So you wait.
"I found a lump, and I didn't deal with it," said Spring Branch resident Melissa Strong, 29. "I waited a whole year. And then found out I had cancer." Not only did Strong, who is the mother of a four-year-old boy, think she was too young to have breast cancer, she thought she was too young for a mammogram.
According to The Rose, a Houston nonprofit organization that provides screening, diagnosis and access to treatment regardless of a patient's ability to pay, you might be too young for a mammogram, but you're not too young for breast cancer.
That's why The Rose established the Young Women's Clinic, specifically for females 35 and younger. According to the American Cancer Society, there are more than 250,000 women living in the United States who were diagnosed with breast cancer at age 40 or younger. Next year, 10,000 more will be diagnosed.
Last year, of the 335 women The Rose diagnosed with breast cancer, 37 were under the age of 40. Of those, 34 had no insurance. Strong was one of them. Her physician referred her to The Rose – a perfect fit because that's where Strong met Dr. Janet Hoagland, who believes "if we save the mother, we save the family."
Hoagland said patients need a physician's referral before coming to the Young Women's Clinic, but if she does not have a primary care physician, The Rose has a network of physicians who will provide a referral at little cost. "Most young women are uninsured," Hoagland said. "Young people figure they don't need insurance yet. So even if they have the ability to insure themselves, they often don't."
Once at the Young Women's Clinic, the patient receives a clinical breast exam and an ultrasound. Hoagland said ultrasound is a better screening tool for younger breasts, which due to density can cause a mammogram to look like "a snowstorm," not providing enough detail.
But that's not to say a mammogram won't be ordered. Strong had an ultrasound and a mammogram, both on the same day. "My rule of thumb is that the breast is mature after the first full pregnancy," Hoagland said. "We do a mammogram if the patient fits into that category, or is over the age of 30 or has family history."
Strong's grandmother died of breast cancer. "Family history is a big, red flag," Hoagland said. "A red flag cannot be ignored." Yet almost 80 percent of breast cancer occurs in women who do not have any genetic factors. If it's cancer, Hoagland puts her uninsured patient in the care of a Patient Navigator at The Rose.
"Some doctors will tell you 'yeah you have cancer, figure it out yourself,'" Strong said. "The Rose, they don't do that. I didn't have to get in that long line to get Medicaid and get denied 300 times. And I didn't have to wait 500 years to get in to M.D. Anderson. It was very soothing and eased my mind a lot."
Strong underwent six months of chemotherapy, followed by a double mastectomy, because she tested positive for the BRCA 2 cancer gene and also underwent radiation. "I think if I had gone when I first felt the lump, it still would have been small enough that I wouldn't have needed radiation," Strong said. "Not to get on my soapbox or anything, but if you feel something, go to your doctor. If the doctor brushes you off, go to another doctor."
Hoagland couldn't agree more. "The woman knows her own breast the best," Hoagland said. "If she says something is different, it's different."
But different doesn't necessarily mean cancer. Ultrasound will show whether a lump is solid or filled with fluid. If it's fluid-filled, it's generally a cyst, which will collapse the moment Hoagland aspirates it with a thin needle. Hard nodules that stick around might be fibroadenomas, a type of noncancerous tumor that is quite common in young women.
"Some women are just fibroadenoma-makers," Hoagland said. "If the fibroadenoma is less than three centimeters, and there are no other risk factors, we follow them every six months for two years to make sure it's not growing. You have them your whole life unless they are surgically removed."
Breast tissue changes that are cyclical, meaning lumps and bumps that come and go on a monthly basis, can often be treated by limiting caffeine intake. Hoagland always enjoys the opportunity to educate young women about breast health.
"There are no silly questions; there are no stupid questions," Hoagland said. "We don't treat people like hypochondriacs.
"While we don't know how to prevent breast cancer, we do know how to detect it early. And women who are proactive are the women who do better."
The Young Women's Clinic is open from noon to 4 p.m. weekdays at The Rose Galleria, 5420 West Loop South, Suite 3300, Bellaire; and from noon to 3 p.m. every Friday and every other Thursday at The Rose Southeast, 12700 N. Featherwood, Suite 260 in Houston.
For more information, call 281-484-4708 or visit The Rose website, www.the-rose.org.
Even though you're frozen, your fingers are still pushing, prodding, palpating.
But you're young. You're busy. It's probably nothing you tell yourself.
So you wait.
"I found a lump, and I didn't deal with it," said Spring Branch resident Melissa Strong, 29. "I waited a whole year. And then found out I had cancer." Not only did Strong, who is the mother of a four-year-old boy, think she was too young to have breast cancer, she thought she was too young for a mammogram.
According to The Rose, a Houston nonprofit organization that provides screening, diagnosis and access to treatment regardless of a patient's ability to pay, you might be too young for a mammogram, but you're not too young for breast cancer.
That's why The Rose established the Young Women's Clinic, specifically for females 35 and younger. According to the American Cancer Society, there are more than 250,000 women living in the United States who were diagnosed with breast cancer at age 40 or younger. Next year, 10,000 more will be diagnosed.
Last year, of the 335 women The Rose diagnosed with breast cancer, 37 were under the age of 40. Of those, 34 had no insurance. Strong was one of them. Her physician referred her to The Rose – a perfect fit because that's where Strong met Dr. Janet Hoagland, who believes "if we save the mother, we save the family."
Hoagland said patients need a physician's referral before coming to the Young Women's Clinic, but if she does not have a primary care physician, The Rose has a network of physicians who will provide a referral at little cost. "Most young women are uninsured," Hoagland said. "Young people figure they don't need insurance yet. So even if they have the ability to insure themselves, they often don't."
Once at the Young Women's Clinic, the patient receives a clinical breast exam and an ultrasound. Hoagland said ultrasound is a better screening tool for younger breasts, which due to density can cause a mammogram to look like "a snowstorm," not providing enough detail.
But that's not to say a mammogram won't be ordered. Strong had an ultrasound and a mammogram, both on the same day. "My rule of thumb is that the breast is mature after the first full pregnancy," Hoagland said. "We do a mammogram if the patient fits into that category, or is over the age of 30 or has family history."
Strong's grandmother died of breast cancer. "Family history is a big, red flag," Hoagland said. "A red flag cannot be ignored." Yet almost 80 percent of breast cancer occurs in women who do not have any genetic factors. If it's cancer, Hoagland puts her uninsured patient in the care of a Patient Navigator at The Rose.
"Some doctors will tell you 'yeah you have cancer, figure it out yourself,'" Strong said. "The Rose, they don't do that. I didn't have to get in that long line to get Medicaid and get denied 300 times. And I didn't have to wait 500 years to get in to M.D. Anderson. It was very soothing and eased my mind a lot."
Strong underwent six months of chemotherapy, followed by a double mastectomy, because she tested positive for the BRCA 2 cancer gene and also underwent radiation. "I think if I had gone when I first felt the lump, it still would have been small enough that I wouldn't have needed radiation," Strong said. "Not to get on my soapbox or anything, but if you feel something, go to your doctor. If the doctor brushes you off, go to another doctor."
Hoagland couldn't agree more. "The woman knows her own breast the best," Hoagland said. "If she says something is different, it's different."
But different doesn't necessarily mean cancer. Ultrasound will show whether a lump is solid or filled with fluid. If it's fluid-filled, it's generally a cyst, which will collapse the moment Hoagland aspirates it with a thin needle. Hard nodules that stick around might be fibroadenomas, a type of noncancerous tumor that is quite common in young women.
"Some women are just fibroadenoma-makers," Hoagland said. "If the fibroadenoma is less than three centimeters, and there are no other risk factors, we follow them every six months for two years to make sure it's not growing. You have them your whole life unless they are surgically removed."
Breast tissue changes that are cyclical, meaning lumps and bumps that come and go on a monthly basis, can often be treated by limiting caffeine intake. Hoagland always enjoys the opportunity to educate young women about breast health.
"There are no silly questions; there are no stupid questions," Hoagland said. "We don't treat people like hypochondriacs.
"While we don't know how to prevent breast cancer, we do know how to detect it early. And women who are proactive are the women who do better."
The Young Women's Clinic is open from noon to 4 p.m. weekdays at The Rose Galleria, 5420 West Loop South, Suite 3300, Bellaire; and from noon to 3 p.m. every Friday and every other Thursday at The Rose Southeast, 12700 N. Featherwood, Suite 260 in Houston.
For more information, call 281-484-4708 or visit The Rose website, www.the-rose.org.
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