For her 35th birthday, Christina Faris gave herself a present that neither her husband nor her friends thought to give. Faris had her first mammogram. The cost of her $20 co-pay may have saved her life.

No history

Faris works for a health insurance firm, so she’s attuned to health issues. And breast care is on her radar because she coordinates her company’s on-site mobile mammography visits that Saint Luke’s provides.

“I knew that 35 is the earliest recommended age for getting a mammogram, and I turned 35 the week of the mobile clinic,” said Faris. “I thought, ‘I should get my baseline reading.’”

“Why?” asked her family and friends. Faris is young and has a healthy lifestyle. She works the treadmill, mows the lawn, doesn’t smoke and has no family history of breast cancer. She’d even had a checkup with her OB/GYN months before. But Faris had made up her mind. “I said, ‘It’s only $20, so why not?’”

No symptoms

The technicians in the mobile mammography unit cautioned her. Don’t be scared if you get a callback, they said. That’s common with first-timers because there’s no baseline to check the X-rays against.

Faris got a callback. She needed a sonogram.

“I started getting nervous when I saw a black blob on the screen,” Faris said. “Then the technicians began measuring it. They wanted it biopsied.”

At Saint Luke’s Center for Breast Care, the staff performed a needle biopsy on Faris’ right breast. A week later, Faris got the call saying the results had come in. “I had a sick feeling in my stomach that something was wrong,” said Faris.

Two hours later, she and her mother-in-law were at Saint Luke’s. Something was, indeed, wrong. Faris had cancer in her right breast. And her hormonal makeup gave the cancer plenty to feed on. Faris was shocked. As far as she knew, she was healthy. She felt fine.

Cancer often doesn't cause symptoms until it's in an advanced stage. Faris' experience demonstrates the importance of breast screening—she had no palpable mass, no family history, and was just 35 years old.

The bad news was that the cancer was aggressive. The good news was that it was in an early stage, and there were a number of treatment options. But first, Faris’ surgeon specializing in breast care, Tammy Neblock-Beirne, M.D., wanted Faris to have an MRI.

“My exam findings felt a larger lump than the imagery was showing,” said Dr. Neblock- Beirne. “With an MRI, we could get a better idea of what was there and then determine the best treatment.”

A second, hidden growth

When Faris walked into the Saint Luke’s East Hospital Center for Breast Cancer a year ago last October, she was only the third breast MRI patient that Ruby Meierotto, M.D., specialized breast radiologist at Saint Luke’s, had treated in the new center. Saint Luke’s has the only dedicated breast MRI in the Kansas City area.

“Most MRI machines focus on the center of the body—the head, chest and abdomen,” said Dr. Meierotto. “But that’s not where the breasts are located. This machine has an elliptical imaging area that follows the contours of the breasts.”

Young women like Faris tend to have dense breast tissue. Dense tissue can obscure cancerous growths on a mammogram. But the MRI’s contrast dye exposes even the most hidden tumors. Faris’ MRI revealed a second area of cancerous growth on the same breast.

Knowing her true condition gave Faris the best chance of achieving her goal of saving her breast. It meant her treatment could be designed to do this while still attacking all of the cancer. So Faris had very targeted chemotherapy first, before her lumpectomy (a treatment sequence known as
neoadjuvant therapy), followed by radiation and a 12-month infusion of medication.

“Had she not had the MRI, the second site of cancer might not have been identified and targeted for removal at the time of surgery,” said Dr. Young. “The combination of the MRI and chemo allowed her to preserve her breast with the best chance for survival and least chance of recurrence.”

Many options

Faris also got tested for the breast cancer gene through genetic screening at Saint Luke’s Cancer Institute. Now she knows she’s not genetically predisposed.

“The doctors and nurses gave me so many resources I could read on what works for me—and the nurses even gave me their cell phone numbers!” said Faris. “I wasn’t left scared and wondering what was going on.”

Knowledge is valuable in the fight. Not every patient needs an MRI, but women should know that this diagnostic tool exists. Most important for patients, said Dr. Neblock-Beirne, is finding a facility that offers both options and experts.

“A facility with specialists is important in getting the best choice of treatments,” she said.

All clear

Faris is now a charter member of the new breast cancer support group Saint Luke’s has started. Her second mammogram, in 2010, was clear. “I’m looking forward to saying I’m a breast cancer survivor,” said Faris.

And to describing how a $20 co-pay just might have saved her life.

Saint Luke’s offers mammograms across the metro area. Learn more about Saint Luke’s mammography services.