May 1, 2011

Attacking the code of silence

Kaitlyn’s Law:

Brenda Peters of Londonderry wants a new law, dedicated to her daughter, that will require essential, life-saving information be included with mammogram results. 

Brenda Peters, left, with two of her three kids, Kaitlyn and Brandon,
outside their Londonderry home. Peters has become a warrior for women
and their right to understand the true risks involved in developing breast cancer.
Union Leader Correspondent
LONDONDERRY -- Brenda Peters is more than a breast cancer survivor.
Since her diagnosis 19 months ago, and the 17 surgeries that have followed, Peters is battled-tested in her fight with cancer, emerging a warrior for women everywhere who she believes are threatened by the code of silence she says surrounds the simple facts of breast density.
She is lobbying for legislation that will make sure this essential, life-saving information is included with routine mammogram results, a bill she calls Kaitlyn’s Law.
“I wanted to dedicate it to my daughter, Kaitlyn, because it’s too late to help me, but not for our daughters,” said Peters.
She regards the bill as something that will “fix the fatal flaw” in current information reporting practices among physicians.
“After a mammogram I had 19 months ago that indicated I had a suspicious area of tissue in my left breast, I also learned that according to the mammogram, I had 94 percent breast tissue and 6 percent fatty tissue. I didn’t know what that meant, so I Googled it, and found that it means I have dense breast tissue, something I’d never heard about before,” Peters said.
She also learned that simple fact meant she had a 75 percent greater chance
 of developing breast cancer than someone with less-dense breast tissue. Considering she’d had eight previous mammograms beginning at the age of 35, and nobody had ever discussed the density of her breast tissue with her, or what that meant in terms of risk, Peters found herself feeling fired up.

Peters dug deeper and discovered that for decades breast density has been routinely observed and rated between 1 and 4 — four being most dense — and that the information is readily available, not only to women but to their physicians. However, if you don’t know what it means, or why it’s significant, chances are you’ll never ask, or be told.
“That information goes to your ordering physician. So for example, my physician got the initial report that after my first mammogram that I was a 3. At some point, I became a 4, which should have been a red flag. Generally, breast density doesn’t increase with age,” Peters said.
Her general practitioner didn’t know the significance of the density rating.
“I think the radiology department assumes the physician will know what these categories mean. There’s a flaw in their whole reporting process. And for me, there’s a 50 percent chance that a mammogram won’t be effective in detecting cancer, because of
 the density factor,” Peters said.
So she requested an MRI, telling her doctor she believed the mammogram may have missed something, given the non-invasive lobular carcinoma in situ already present in her left breast, for which she was prescribed Tamoxifen and told not to worry. After some resistance by her physician — and mostly to “make her feel better” — Peters got the MRI.
“They found a mass consistent with malignancy in my right breast. The tumor was 2 centimeters and was invasive,” Peters said.
Her dense breast tissue masked the underlying tumor, which was not visible on previous mammograms.
As a result, she had both her breasts removed, followed by chemotherapy. She also has had her ovaries removed and will be on estrogen-inhibiting drugs for five years. The multiple surgeries have all been the result of systemic staph infection.
Last year Peters was able to do a survivor lap during the annual Relay For Life fundraising event. This year, she is captain of team “Who’s Dense?” which will be using pink flamingoes as props to help raise awareness about the need for a Kaitlyn’s Law here in New Hampshire.
Peters is also working with state Reps. Karen Hutchinson and Phyllis Katsakiores to introduce Kaitlyn’s Law, which
 would improve the way physicians and patients are notified about mammogram results, specifically when density is an issue.
Peters said there is a federal version of the law that is also in the works.
“Participating in the Relay For Life will be a very emotional thing for me this year,” said Peters. “Pushing for Kaitlyn’s Law is one way for the women of New Hampshire to catch their cancer early.”
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