Breast cancer screenings decreased in 2020. Here's why early detection is important.
FORT WALTON BEACH — When Shannon Lehman, 48, found out she had been diagnosed with stage two breast cancer, her first thought was “Am I going to die? And what do I need to do to not die?”
Lehman was diagnosed with breast cancer this spring, making her one of 2.3 million women who were diagnosed with breast cancer last year. However, fewer women have been getting screened for breast cancer because of the COVID-19 pandemic.
As breast cancer awareness is again brought to the forefront during October, physicians and survivors like Lehman encourage women to either get checked or start performing self-examinations.
“People are not coming as much for a variety of reasons,” said Dr. Bradley Brobeck, a radiologist at Fort Walton Beach Medical Center. “We want women to get back on their regular yearly cycle to maximize that sensitivity in catching things that are in the early phases, where we have a better cure rate.”
The American Cancer Society recommends that women without symptoms start getting screened for breast cancer on a yearly basis around the age of 40. Most insurance carriers will cover a mammogram once a year for women over 40.
The importance of early detection
Lehman accidentally discovered that something was wrong after noticing blood on her chest one day.
“I was overdue for a mammogram, and then 2020 happened, so everything got behind,” she said. “What happened was I happened to have on a white bra one day and I noticed on my right side it looked like there was dried blood on it.”
Thinking that was strange, Lehman began feeling around her chest and noticed that one side of her breast felt very hard. Had she been doing monthly self-examinations, Lehman said she believes she would have found the lump sooner.
“We occasionally have women come in that have a palpable lesion that they discover on their own, which is an important way for detection of breast cancer,” Brobeck said.
Brobeck said it is recommended that women do a self-examination around the same time each month so they can recognize changes in the density within the breast and any lumps or swelling.
Other symptoms of breast cancer include pain in any area of the breast, redness or flaky skin and, like Lehman experienced, bloody discharge.
“That’s something that you need to get checked out and make sure that there’s nothing underlying what’s causing the discharge,” Brobeck said.
Stage two breast cancer is still considered relatively early. However, physicians typically hope to catch breast cancer in stage one. Brobeck said early detection drastically increases survival rates.
According to the American Cancer Society, when breast cancer is detected early and is in the localized stage, the five-year survival rate is 99%.
“It increases your survivability,” Brobeck said. “If we can catch something in stage one cancer that’s usually under 2 centimeters, you have a much higher survival rate than if you catch something later, or that has already spread to lymph nodes or other parts of the body.”
'I just wanted the cancer out of me'
Lehman said she was devastated when she was diagnosed. Her initial thoughts were focused on survival for her 8-year-old daughter and husband. In May, she had a bilateral mastectomy to remove both breasts, even though only one was diseased.
“When you get diagnosed you’re absolutely terrified of what could happen, so I wasn’t thinking reconstruction,” Lehman said. “I just wanted the cancer out of me.”
Later she found out that her healthy breast had cancerous cells in it, and the decision she had made to remove both of them came as a “big relief.” Although she is now about halfway through the process, Lehman said it still doesn’t seem like she’s anywhere close to done.
In November she will be finished with her last six weeks of chemotherapy. She then has one more surgery, healing and radiation therapy to endure.
Helping her along the way has been her family and a local support group in Fort Walton Beach she joined shortly after she was diagnosed.
“I was just trying to reach out to anyone in this area who was going through the same thing that I was,” Lehman said.
'Talk to others who are dealing with it'
The Bosom Buddies Support Group has mostly limited its meetings to online the past year, and recently began meeting for lunch once a week with those who are able to meet in person safely.
While going through chemotherapy and other treatments, many have chosen to limit social interactions to protect their health.
Still, Lehman said it has been helpful to connect with other women who have endured or are going through similar experiences. The group provides support for anyone who has been diagnosed with breast cancer, whether it was several years ago or yesterday.
“Even if it’s just through email, it helps you feel like you’re not so alone in the whole process to talk to others who are dealing with it,” Lehman said. “And I’m fortunate. I’ve got my husband and my daughter here, so they’re a great support network, and friends.”
Although the experience can be frightening at times, Lehman said she has found comfort in living for each day.
“I had a very wise friend who went through breast cancer who told me ‘Just don’t think about tomorrow. Think of today. Enjoy today. Put tomorrow out of your mind,'” Lehman said. “That helps me when I start having an anxiety attack or feel the way I feel.”
Bosom Buddies Support Group
Shirley Carnes became a member of the Bosom Buddies Support Group over 30 years ago after she was diagnosed with stage two breast cancer. Not long after, she took over as the facilitator of the group and has been in the position ever since.
"Sometimes part of our stories are when you’re recuperating or once you’re through with your treatment, is that you want to go through sort of a payback period,” Carnes said. “You want to give back, and if nothing else, to participate in cancer awareness programs to help others and help others prevent it.”
A good support system is a crucial part of recovery, she said. Some women need that support network for much longer. Carnes said she has been lucky that her cancer has stayed in remission.
Other members of the group are coping with metastatic breast cancer, a stage four breast cancer that has spread to another part of the body such as the liver, brain, bones, or lungs.
“With early detection, we hope to prevent recurrence, but recurrence happens to be a part of our lives,” Carnes said. “We have it all in the group.”
Breast cancer risk factors
Members of the group vary in ages from Lehman, in her 40s, to others who are in their mid-70s.
The risk of developing breast cancer generally increases with age. About 85% of breast cancer diagnoses each year are among women aged 50 or older, according to the American Cancer Society.
Certain factors like family history can also increase risk. Cases are extremely rare for women in their 20s, but Brobeck said he has seen cases of breast cancer in women as early as 30 years old.
“Women with a history of breast cancer in their family that’s either strong or early in age, sometimes they’re recommended to have screening starting at a younger age,” he said. “We’ve seen cases in the early 30s, and sometimes women start screening at the age of 30 if they have very high-risk factors.”
The American Cancer Society recommends that women begin performing monthly self-examinations as early as high school. Given one word of advice to share with other women, Lehman said she would urge them to examine their breasts on a regular basis.
“Please examine your breasts in the shower once a month. You will discover something a lot quicker than a mammogram will,” Lehman said. “Be aware of your own body and be aware of what’s going on inside and outside of it.”