By Dr. Meghna Krishnan, M.D. 
Breast imaging fellowship trained radiologist practicing at Wheaton Franciscan Healthcare - Iowa

Breast cancer continues to be the most common cancer in women. Two thirds of new breast cancers are diagnosed in women without a family history of breast cancer. Having a mammogram that can detect cancer in its earliest, most treatable stage decreases the chance that a woman will need extensive treatment and/or die from breast cancer.

The death rate from breast cancer has declined steadily by over 30% since 1990, when women started obtaining annual screening mammograms. Breast tomosynthesis produces a threedimensional view of the breast tissue that helps radiologists identify and characterize individual breast structures without the confusion of overlapping tissue.

This type of state of the art imaging benefits all screening and diagnostic mammography patients. Breast cancer screening with tomosynthesis, when combined with a conventional 2D mammography, has a 40% higher invasive cancer detection rate than conventional 2D mammography alone. Tomosynthesis technology gives radiologists increased confidence with up to a 40% reduction in recall rates. With breast tomosynthesis digital mammography, there is a better chance to diagnose breast cancers at earlier and more treatable stages. In the fall of 2014,

3D mammography (tomosynthesis) came to the Cedar Valley. At these facilities, given cutting edge technology, there is no increased radiation to the breasts from 3D mammography and the radiation dose is equal to that of having a conventional 2D digital mammogram. At these facilities, merely less than 5 percent of women are asked to return following an inconclusive screening mammogram, thanks to the cutting edge technology of 3D mammography and experienced breast radiologists.

The majority of these recalled women simply get another mammogram and/or ultrasound for clarification. Only 1 to 2 percent of these women proceed to have a needle biopsy. Short-term anxiety from test results is shown to have no lasting effects and does not outweigh the over 30 percent reduction in breast cancer deaths and thousands of lives saved each year by mammography screening.

The NAPBC accredited Covenant Comprehensive Breast Center and the Covenant Cancer Treatment Center have a strong Breast Program Leadership team and a highly engaged Cancer Committee that is comprised of breast surgeons, breast radiologists, pathologists, medical oncologists, radiation oncologists, and many trained breast health professionals who concur with American College of Radiology guidelines for breast cancer screening for women with average risk.
These include:
• Annual screening mammography starting at age 40
• Monthly self-breast exam
• Clinical breast exam (at least annual)

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by Valerie Aquilera

I have wanted to be a mother as long as I can remember. Growing up, I played with dolls and Barbie's. and formed my own fantasy families. Care Bears and Cabbage Patch dolls made up a large family that I got to parent. I got to feed, love and care for a big slew of "children."

God had created this longing in my heart. He had a plan for me. My calling has always been to be a mother.

In 2011, this dream was just beginning. I was 27, and I had snagged the husband of my dreams. I had a two year old daughter and a one year old son, and had hopes for more children. I desired a large and loud family.

And my husband and I were on our way to that, until I walked into the breast care doctor's office on February 28th. That day, I learned I had stage two breast cancer - Estrogen positive - Progesterone positive – HER-2 positive. From May 2011 to October 2012, I received chemotherapy.

I was told to be on birth control because a fetus would suffer dire consequences (deformities or death) if I got pregnant during my chemo. After that, I was supposed to take tamoxifen, the drug that would decrease my levels of progesterone and estrogen, for five years.

I was angry. I mean, really angry. It isn't the right way to deal with things, but I put God on the "silent treatment." I couldn't believe He had just given me my dreams, a new and young family, and then allowed me to be sick. Allowed for me to be only able to watch my children play from my spot on the couch or hear their giggles down the hall from under my bedcovers. My husband had to do almost all the work parenting our babes, and I certainly wasn't being the mother I had dreamed to be.

I worried about not seeing my children off to their first days of kindergarten, or whether they would remember me if I suddenly got a serious infection and died. (Morbid, yes, but it is a reality for some.)  I met a young woman and spent every Friday with her for months, as we lounged, talked and slept during treatments. I saw her one week, and attended her funeral the next. Reality - it hits, and hit me hard when she died.

I was angry with God because He gave me this calling to be a mother. He instilled in me a desire to take care of children. And here I was, laid up, barely able to take care of myself, worrying about leaving children motherless. And even after chemo was finished my doctor's advice was not to have more pregnancies, because a pregnancy would increase the hormones that helped my specific type of cancer to grow.

I lost my breasts, my hair, and the ability for more children. Honestly, I grieved the loss of another pregnancy, or another biological baby, more than any other part of the cancer situation. Some days I was bitter, other days I was depressed.  At that time, anyone would have said that the anger, the sadness, the disappointment was justified.

Here's the deal though- God has a purpose for everything. And in the midst of a cancer diagnosis/ treatment, it is sure hard to see a silver lining. It's easy to see that loss, and be hopeless.

Here's what God did for me: He gave me more children. He didn't let my dream of a big family die. After all, He had given me this calling. He had placed the longing in my heart. But He had more in store for me than I could have imagined, or planned for.

In 2013, a beautiful dark haired girl was born miles away and without my knowledge, but four days later a social worker carried her into my home. Almost a year later, a judge declared her my daughter, as if I had given birth to her. And I have loved her as if she was of my flesh since the moment she entered my life.

Two and half months after my daughter's adoption finalization, we got an early morning wake up call. Our baby boy was about to be born. We woke our three children up, packed them in our minivan and flew to the hospital, two hours away. It is amazing, although not what we had planned, that his whole family, parents and siblings were there to meet him within his first few minutes. I watched him breathe his first breath and cry his first cry. And I realized that THIS family, the one God created just for me, was my satisfied longing that I had held in my heart all my life.

Cancer didn't mess with my purpose, and it couldn't hold me back from being who I was made to be. Cancer was just a detour that beautifully led me to my destination. Cancer created the urgency in my heart to adopt, and because of that, we were licensed foster parents in just the right time to take in our youngest daughter, and then her younger brother.

Today, I am a mother to four wild, loud, God-loving children. And if I get cancer again, I will better understand that it can't rob me of me. I won't childishly put God into the silent treatment. I will be able thank Him for what He has already taken and made good.