While breast cancer comes as a surprise to most who are diagnosed, some patients know their risk ahead of time.
This is the case for a patient of Dr. Colleen O'Kelly Priddy, a breast surgical oncologist and the medical director of Mission Hope's breast center in Santa Maria. The patient carries a genetic mutation that significantly increases her chances of breast cancer, so she made the choice to get a precautionary mastectomy.
- Photo Courtesy Of Tenet Health Central Coast
- GET SCANNED This 3D Imaging Machine at Selma Carlson Diagnostic Center in San Luis Obispo is used to detect breast cancer.
"She was scheduled to have her regular screening mammogram, and then right after that she was scheduled to have her prophylactic mastectomies," O'Kelly Priddy said.
But when COVID-19 hit, everything got pushed back for several months.
"Once she finally went back in and got her mammogram, she actually had a cancer," O'Kelly Priddy said. "Instead of being able to just have her risk-reducing mastectomies, she ended up having to have chemotherapy, then have the mastectomy, and then have radiation afterwards. It turned into a much bigger deal."
While the genetic mutation that this patient has is rare, it is highly recommended that every person with breasts over a certain age get screened annually for breast cancer. But scans on the Central Coast plummeted last year, and now doctors are seeing more late-stage diagnoses as a result.
"I have seen this in my own practice with delay in diagnosis due to COVID illness and women not coming in last year for mammograms or exams," said Dr. Rosa Choi, breast surgeon with Ridley-Tree Cancer Center in Santa Barbara County. "I did as much telemedicine last year as possible and picked up cancers when women reported having lumps."
Prognosis for breast cancer tends to be better when it hasn't spread to the lymph nodes yet, but Choi said the medical community is seeing more of that.
"Reports from [the] United Kingdom and Canada suggest that there is a six month delay in diagnosis with women coming in with larger tumors and more node positive disease," Choi said. "This may translate into [an] increase in breast cancer mortality by 30 percent in the next five to 10 years."
Kitt Kelly, oncology patient navigator at Sierra Vista Regional Medical Center, said he has anecdotally witnessed more patients with late-stage breast cancer.
"There is no escape of accepting that, without screening, all the findings are later than they should be," Kelly said. "If you have a breast cancer that's growing, and you wait 18 months, you're already way behind."
With early findings, the chance of curing breast cancer is 94 percent, Kelly said. But with a late finding, chances of curing it drop rapidly, "with a lot of suffering along treatment."
"This is not something that needs to happen," Kelly said. "This is something that would not happen if the person [got their annual mammogram]."
Even before March 2020, doctors faced barriers in getting people to come in for their annual scans. The pandemic only compounded those challenges.
"When life is good and busy, and people are healthy and asymptomatic, they tend to put screening at the bottom of their list," Kelly said.
Others avoid their annual mammograms because of radiation concerns.
"I reassure women that the dose of screening mammogram is equivalent to three months of ambient radiation from the environment, so it is safe to get mammograms every year," Choi said.
Income can also discourage someone from getting their annual screening, but Kelly emphasized that most medical insurance covers mammograms, and for those who are uninsured, there are options.
"Throughout the entire state of California, there is a program called Every Woman Counts," he said. "It's run by Medicare. You can walk in or make a simple appointment and get your mammogram, and your care would be the same standard as those who have insurance. People think that because it's free, and without a written order by a primary care physician, that somehow they will get a lesser care. That's not true."
According to the American Cancer Society, breast cancer screenings are optional from ages 40 to 44. Once someone turns 45, scans are recommended every year. For ages 55 and older, mammograms are recommended once every two years, though annual screening is still an option.
In honor of Breast Cancer Awareness Month, Tenet Health is extending its hours to Saturdays at two of its diagnostic centers in October to encourage people to get their mammograms. At Selma Carlson Diagnostic Center in San Luis Obispo, patients can snag appointments on Oct. 9, 16, 23, and 30. At Templeton Imaging, appointments are now available for Oct. 9, 16, and 23. Δ
Staff Writer Malea Martin can be reached at email@example.com.