Barbara Borland, medical director at the Susan Cheek Needler Breast Center at Morton Plant Hospital, demonstrates a full field digital mammography system.
CLEARWATER – Darnella Wadsworth reached over to scratch her armpit when her pinky brushed against a lump in her breast. She thought it felt unusual, but, then 31, she figured it was probably just fibristic tissue.
Later, while on a walk with a friend, she casually asked her friend if she had any lumps on her breasts. The friend immediately got worried and made Wadsworth go to her doctor.
On Aug. 1, 2008, Wadsworth was diagnosed with Stage II invasive ductal carcinoma breast cancer.
Women have about a one in eight chance of getting invasive breast cancer sometime in their lifetime, according to the American Cancer Society. After skin cancer, breast cancer is the most common cancer in women, although lung cancer is the No. 1 killer, said Dr. Barbara Hall Borland, medical director of breast imaging and intervention at Morton Plant’s Susan Cheek Needler Breast Center in Clearwater.
Fortunately, regular mammograms can catch the cancer in its early stages when it is easily treated and has an excellent survival rate, she said.
“The prognosis of breast cancer is very good,” Borland said. “It’s only in women whose cancer is found in the very late stages and have the very aggressive forms of breast cancer that die from it.”
Stage I breast cancer has a 96 percent five-year survival rate, Borland said. Although treatment is unpleasant, it is effective, she said.
There are several ways to screen for breast cancer, Borland said, including mammography, ultrasounds and MRIs, although mammography is the “gold standard.”
“It has the highest success rate of screening a population of women effectively, both in terms of medical effectiveness and cost effectiveness,” Borland said.
Women should get yearly mammograms beginning at age 40, she said, unless they are at high risk for breast cancer. High risk people include a family history of either women in every generation consistently getting breast cancer or having a close family member, such as a sister, get breast cancer before she is 50. High risk also includes people with a personal history of cancer or having a pre-cancerous condition, she said.
A mammogram is a low dose X-ray that shoots the invisible rays through the breast, and an electronic pad beneath the breast reads the signals that make it through. If the breast was merely a sac of water, the rays would go right through and create an image of a big, white blob, Borland said. However, since breasts are made up of fat, fibrous material, calcium and other materials, it scatters some of the rays. This scattering creates a picture that radiologists then can read.
It is crucial to know who is reading your mammogram, Borland said.
“There’s a huge difference in physicians who specialize in doing only breast cancer detection and those who do it as a side deal while doing everything else,” Borland said. “And they’re the first ones to admit it. I know. I was a general radiologist for 13 years before I went into this, and I knew that my level of expertise in breasts was okay. It was acceptable. But I have learned so much more and have become so much more in tune with the nuances.”
At all of Morton Plant’s imaging centers, only breast specialists read the mammograms, Borland said.
For Darnella Wadsworth, now 32, of Dunedin, disbelief hit her first when she got the results of her biopsy.
“I said to (the woman on the phone,) ‘Are you sure you’re trying to call Darnella Wadsworth?’ I didn’t believe it,” she said. “I thought, this is crazy. How can I have cancer? I’m so healthy.”
After the shock wore off, Wadsworth decided to arm herself with knowledge. She joined cancer meetings and dove into the American Cancer Society’s resources at www.americancancersociety.com. She wanted to know the terms, definitions and what to expect before doctors talked to her about them.
Wadsworth had Stage II, Grade III cancer and underwent six rounds of chemotherapy, 35, rounds of radiation and a partial mastectomy. Her last treatment was on June 4 of this year.
Treatment made Wadsworth so weak it could take her hours just to walk to the kitchen, she said. Although she never considered dying from her cancer, her biggest fear was that she would become paralyzed or never regain her strength to do the things she loved.
“I was very nervous that I wouldn’t be able to run on the treadmill anymore or do an elliptical or go for a jog outside or ride my bike,” Wadsworth said. “I did try. When I had chemo, I pushed myself. I got on my bike and tried to ride it and it was just impossible. Or I’d go for a walk around the block and I only made it down the street. I just tested myself to see how far I’d come along.”
The first time Wadsworth got on the elliptical machine after chemotherapy, she couldn’t even move it, she said. She pushed and pushed, but it would not budge. After time and lots of effort, Wadsworh can easily run a few miles again, she said.
Throughout having cancer, Wadsworth kept a positive attitude that has remained with her.
“I’m much happier,” Wadsworth said. “I really don’t have any more bad days. I don’t even waste my time. Things don’t get me aggravated anymore. Maybe because I’m a lot more patient having to deal with all this hospital stuff. It makes you patient.”
Before her cancer, Wadsworth used to be a list person. Each day she would write out a list of what she needs to do, but she does not do that anymore. She just does the best she can at work and at school and does not stress the small stuff, she said.
“I realize that there are a lot of other people where their situation is a lot worse,” Wadsworth said. “So it’s important to stay as positive as possible.”
Breast cancer treatment is not as bad as it used to be, Borland said. Now, partial mastectomies, or “lumpectomies,” are the norm, whereas in the early years, the entire breast and all the muscles down to the ribs were removed. However, it has now been proven that a partial mastectomy with radiation is as effective as a full mastectomy, Borland said, and reconstructive surgery can make women look completely normal while wearing clothes.
Treatment always includes some sort of surgery because the cancer has to come out, Borland said. Then radiation helps kill any residual cells. Healthy cells are not harmed by the radiation, Borland said, although people will get temporary thickening of the skin, and that breast may hold more water for a while after treatment.
Chemotherapy is given to people whose cancer has spread to their lymph nodes or beyond the breast or if the patient is a younger woman, Borland said. Breast cancer is the most dangerous if it has spread to the rest of the body, but even then, Borland said, the survival rate is well over 50 percent.
The best defense against cancer is to eat well, exercise and get regular mammograms, Borland said.
“The whole thing is early detection,” Borland said. “That’s the whole key with having a good outcome from breast cancer. Getting mammograms doesn’t keep you from getting cancer, but it allows us to find it at a very early stage where it’s absolutely curable.”
Women without health insurance may contact the Pinellas County Health Department to see if they qualify for one of two programs that provide assistance with breast cancer screening. The federally funded program provides mammograms to women ages 50 and older. A privately funded program is the Mammography Voucher Program which helps women who do not qualify for the other program. Through that program, women can get free screenings, free mammograms, free diagnostics, and sometimes even free cancer treatment, Borland said.