Karen Ibach of Ansley considers herself lucky. A little over a year ago, Karen was diagnosed with breast cancer - but thanks to a routine mammogram it was caught in the very earliest stage, and because of that she is a breast cancer survivor.
Karen has always been diligent about having annual mammograms and doing self exams. She has had her mammogram every year in November for the past 30 years, and until 2010 all had been normal.
But this time, November 2010, it wasn’t normal. The radiologist spotted several areas of calcifications in one breast, and Karen was told she would need to have a lumpectomy. When she met with the surgeon in Kearney, she got somewhat of a shock. The surgeon didn’t recommend lumpectomy at all.
Due to the numerous tiny calcifications, too small for the surgeon to be able to see well and accurately remove, a mastectomy was necessary.
“It took me a while to wrap my brain around that. But you just have to adjust,” Karen recalls.
On Valentine’s Day, Feb. 14, 2011, Karen underwent surgery to have her breast removed. Though there were many calcifications, tests revealed only one invasive cell. She required no radiation or chemotherapy following surgery.
Karen was also lucky in that she didn’t have to have any lymph nodes removed, making her recovery after surgery much easier. She says the recovery “really wasn’t that bad”, and that she didn’t have a lot of pain.
“The thought was really much worse than the actual surgery,” Karen says.
“But she has a high tolerance to pain anyway,” her sister, Olive Nielsen, adds. “She really does!”
Karen also opted to have genetic testing done, and was relieved to find out that her cancer will not be passed on to her family. “That gives me lots of peace of mind,” she says.
“In my opinion, you have a much better chance of being a breast cancer survivor if you have regular mammograms,” says Karen. “If women want to protect themselves they really need to have regular mammograms done. More women in Custer County need to jump on the band wagon!”
Karen isn’t the only one who thinks not enough women in Custer County take advantage of the state-of-the-art mammography equipment available here. Compared to demographics for other Nebraska counties, Custer County has a lower population per square mile, a higher percentage of residents over the age of 65, a higher percentage of uninsured residents, a higher percentage of Medicare enrollees, and a lower compliance rate to mammography recommendations.
The Salon Project
Those statistics are alarming, and have prompted action from Good Samaritan Cancer Center in Kearney. They have joined forces with Custer County hospitals and clinics to educate area women and encourage them to have regular mammography testing.
It is called The Salon Project. Licensed cosmetology salons in Custer County were contacted by phone, given a brief explanation of The Salon Project, and asked to indicate interest. Fourteen Custer County salons indicated interest. Salon owners estimated they could distribute up to 900 handouts during a two-week time frame.
The goal of the project is to increase awareness of, and the likelihood of adherence to, mammography recommendations identified by the American Cancer Society.
It's natural to ask, "Why are mammography rates in Custer County lower than those for Nebraska?" Simple question. Complex answer.
According to Carol O’Neill, Rn, BSN, OCN (r) with Good Samaritan Cancer Center, here are some general reasons why women do not obtain mammograms:
* Unaware of breast cancer risk
* Unaware of or confused by recommendations
* No time/too busy
* Child care issues
* Apathy about their health or screening behaviors
* Don't' recognize the need since they have no symptoms
* Don't' recognize the need because they check own breasts or doctor performs exam
* Don't' recognize the need because they have no family history
* Feel they're too old
* Fear of radiation
* Fear of pain
* Other medical problems are more important
* "If I have cancer, I don't want to know" attitude
* Distrustful of test results/ doctors/hospitals/medical system
* Cost - uninsured, underinsured, deductible costs
* Lack support from family/significant other/peers
Custer County's rural geography and specific demographics may present additional barriers:
* Distance to screening facilities increases travel costs and lengthens travel time
* Older population may be less mobile
* Issues for those uninsured and underinsured
* Strong rural work ethic promotes an attitude of "The family/farm/ranch/everyone else comes first"
* Women isolated geographically may have fewer one-on-one and peer group interactions resulting in less peer support to take care of themselves
“"Breast cancer is serious and women are often frightened by the very mention of it - understandably so,” says O’Neill, project coordinator. “In addition to feeling fearful, women are busy, they may be strapped for resources, and they may feel their day-to-day life is too complicated to give a second thought to a tension-filled subject like breast cancer. Taking and making the time to be screened may not be easy, but a mammogram is the best tool available for early detection of breast cancer and early detection brings the best chance to survive and thrive."
During The Salon Project campaign, cosmetologists will wear an attention-catching lapel button based on the theme “Take Care of the Girls” with the intent of raising curiosity and eliciting inquiries from salon patrons.
When asked about their lapel buttons, they’ll answer, “We’re helping educate women about breast health and we have a handout for you.”
Participating cosmetologists have handouts that contains pre-packaged snack cakes, partially revealed to resemble breast cleavage, with the theme “Take Care of the Girls” printed on the handout.
The handout will include printed information regarding:
Breast cancer facts, self assessment recommendations, mammography recommendations identified by the American Cancer Society, an Every Woman Matters flyer, website links to American Cancer Society and Every Woman Matters, a hard-copy, postage-paid survey, and a website link for participants who prefer to complete a survey on-line.
Cost can be a prohibitive issue for some women who might otherwise obtain a yearly mammogram, but there are programs available. Every Woman Matters provides financial help for women to receive annual health check-ups.
The program is for women age 40 through 74, with limited or no health insurance and low or moderate income. Some of the services Every Woman Matters pays for include:
• Pelvic exam with Pap test
• Clinical breast exam
• Breast self exam
• Blood pressure check
• Cholesterol check
• Blood sugar check
• Colon cancer screening
• Biopsies and other tests to diagnose breast and/or cervical cancer
For more information on the Every Woman Matters program call Central Nebraska Community Services at 800-736-7491 ext 145.
Women in Custer County also have the distinct advantage of having not one, but two facilities with state-of-the-art digital mammography machines - Jennie Melham Medical Center in Broken Bow, and Callaway District Hospital. These new machines not only reduce the discomfort of a mammogram, most importantly they allow radiologists to see tissue more clearly than ever before. This, in turn, allows potential problems to be caught earlier, thus increasing the chance of survival.
The goal of The Salon Project is to get women talking about a subject that is sometimes uncomfortable to talk about - breast health.
The project is also designed to educate women on the resources available right here in our area, and the importance of utilizing those resources.
"The Salon Project uses a light-hearted approach but delivers a serious message, engaging the brain via the funny bone,” O’Neill explains. “But most of all it presents clear, credible information and encourages candid, supportive discussions between women about breast cancer and the benefits of mammograms."