Kingman woman knows importance of prevention firsthand

HOLOGIC/Courtesy<br>
Teri Williams, left, and Dr. Christopher Johansen stand with KRMC’s tomosynthesis breast imaging machine, which diagnosed Williams with a breast tumor in late September. Williams and Johansen are partners in a program that provides low-cost or free mammograms for uninsured or underinsured women.

HOLOGIC/Courtesy<br> Teri Williams, left, and Dr. Christopher Johansen stand with KRMC’s tomosynthesis breast imaging machine, which diagnosed Williams with a breast tumor in late September. Williams and Johansen are partners in a program that provides low-cost or free mammograms for uninsured or underinsured women.

Teri Williams knows about early detection and mammograms. She is a communication specialist at Kingman Regional Medical Center and built the hospital's Catch It Early program, which helps ensure that as many women as possible have access to mammograms.

So it's not surprising that she's speaking at the hospital's annual breast cancer luncheon Thursday.

She's not doing it as a program representative, however. She's a cancer survivor herself.

During her annual mammogram at the end of September, Williams was diagnosed with a small lump in her breast.

"I got the results on a Friday and immediately had my surgery to remove the lump scheduled for the next week," she said. "I've done tons of research on this stuff. I knew what the next steps were, but when someone tells you you have cancer, you can only think, 'What do I do now?' 'What's next?' 'How do I tell my family?' "

It was hearing those same questions over and over again from local cancer patients and survivors that drove Williams to apply for and get a grant from the National Breast Cancer Foundation to hire a nurse navigator, Kingman native Shelly Rodriguez, for breast cancer patients.

As a nurse navigator, Rodriguez's job was to help breast cancer patients understand each step of their treatment and provide support. She also created a breast cancer support group at the hospital.

Rodriguez had just announced that she would be leaving the Catch It Early program for a job at KRMC's Cancer Care Center.

"I was talking with (KRMC radiologist Dr. Christopher) Johansen during my mammogram about how we were going to replace her when he found the lump," Williams said.

Tests showed that her tumor was a slow-growing form of breast cancer that is unlikely to return. Williams will receive targeted radiation therapy but will not have to have the breast removed.

"Luckily, they caught it early," Williams said. "This is why annual mammograms are so important and why all women over the age of 40 need access to them.

"After watching my mother get diagnosed and treated for breast cancer, no matter how busy I am, I always make time for my annual mammogram," she said.

It was her mother's quiet determination to handle whatever life threw at her, including breast cancer, that inspired Williams to create KRMC's Catch It Early program.

The program partners with Arizona's Well Woman Health Check program to help low-income, uninsured and underinsured women get access to free or low-cost mammograms.

Her mother was diagnosed when Williams was a teenager.

A very observant doctor was able to catch the lump early during one of her mother's mammograms. Surgeons removed the affected breast and all of the lymph nodes on that side of her mother's body.

The technology wasn't as advanced as it is today, Williams said, and at that time, doctors routinely removed all of the breast tissue and lymph nodes on the affected side of the body in order to prevent the cancer from spreading.

The use of mammography was about 10 years old when Williams' mother was diagnosed.

It was a new form of breast exam technology, tomosynthesis, that led to the discovery of Williams' tumor.

A mammogram uses X-rays to create an image of the breast. Radiologists use the images to look for suspicious masses within the breast tissue.

Mammograms are usually able to catch tumors before they become large enough for a woman to feel them.

The earlier a woman can catch a tumor the easier it is to treat and more likely she is to survive, Williams said.

However, as with all technology, mammograms have drawbacks.

The equipment sometimes has a hard time spotting small tumors, especially in women who have very dense breasts, like Williams.

Patients are sometimes called back for a second mammography because a radiologist can't tell if a suspicious area on the first image is a tumor or just normal tissue.

Tomosynthesis also uses X-rays, but instead of creating a two-dimensional image, the machine takes a number of pictures from various angles.

A computer then assembles the images into a three-dimensional picture that allows a radiologist to examine the breast from multiple angles, which makes it easier to spot abnormalities in dense tissue like Williams'.

"When they went back and looked at my previous mammograms, they could see the lump, but only because they knew where to look, " Williams said. "It sounds cheesy, but it actually may have saved my life."

KRMC purchased a Hologic Selenia Dimension breast tomosynthesis system in 2011, after Johansen completed a fellowship using the device at Massachusetts General Hospital.

As soon as he returned from the fellowship, Johansen started pushing to get the technology here, Williams said.

Kingman was one of the first hospitals in the nation to purchase one of the machines.

"Mohave County has much higher rates of breast cancer than the national average," she said.

Williams attributes this increased rate in breast cancer to the large number of women in the area who don't have insurance or are underinsured. Some of these women have never had a mammogram.