There’s more to consider with breast health than cancer
One diagnosis sometimes leads to another, and in the case of Gina Amabello, that turned out to be life-changing, possibly life-saving.
Last year, Amabello, 41, went to the emergency department at Cape Cod Hospital with pain in her
right breast. Although Amabello is a community health worker with Tufts Health Plan Senior Care Options, she was skittish about hospitals. When she was 37, a hysterectomy turned into a months-long ordeal when she was misdiagnosed and eventually discovered to have sepsis. She was scared that not only would her body betray her again but that clinicians might miss it. “Shell-shocked” is how she describes it.
But the breast pain was persistent enough to send her to the ER twice. The second time she was referred to Jill Oxley, MD, FACS, at Cuda Women’s Health Center in Hyannis, who saw her the next day.
She was eventually diagnosed with a 3.5-centimeter breast abscess directly under her nipple – one that was persistent, taking more than 10 months of aspirations, antibiotics and biopsies to cure. “It was very scary. The infection would go, then it would come back,” she said.
Nonetheless, while being treated at Cuda, her faith was restored.
“They took care of me, they felt like sisters, they listened to me,” said Amabello, who lives in Dennis. “Through one of the worst things in my life, I met a group of angels…the most professional, kind, empathetic people you’ll meet. And the most brilliant. And they listen. They respect you as a woman, they respect your voice.”
Fortunately, the abscess was not cancerous. But, it did lead to an evaluation to see if she qualified for the Cuda’s High Risk Cancer Program, managed by Stephanie Ellis, NP. When a mammogram – Amabello’s first ever – revealed she had dense breasts, she was enrolled in the Center’s high-risk program. She will now have annual mammograms, breast MRIs and clinical breast exams – a care plan that acts as a cancer early-warning system and could potentially save her life.
Amabello’s case also points out the importance of getting the right experts involved, Ellis said.
“She had a very unique situation,” she said. “We ended up getting infectious disease (physicians) involved to make sure we had her on the right course. And because she came in with an abscess, I ran an assessment. She might not have gotten that high-risk assessment without the abscess.”
While dense breasts are not a problem in themselves, they can make it more difficult to spot cancer on a mammogram. That increases the risk of interval breast cancer – cancer that is diagnosed within 12 months of a normal mammogram result, according to the National Cancer Institute. Nearly half of all women over 40 have dense breasts, according to the Institute.
“Dense breasts lower the accuracy to be able to see all the way through the breast,” Ellis said. That’s the reason people with dense breasts in the high-risk program also get annual MRIs.
More to Breast Health
But Amabello’s case also shows that cancer isn’t the only health threat to breasts, Ellis said. Patients can get cysts that have to be drained; non-cancerous masses such as fibroadenoma; cellulitis, which is an infection of the skin; and, mastitis, an infection common among breast-feeding moms. And, often, the cause of breast pain is non-medical. For example, caffeine and smoking seem to contribute, Ellis said. And then there’s the issue of bra fitting.
“The number one reason for breast pain is a bra that doesn’t fit," she said. "Sometimes a patient will say, ‘I just lost 30 pounds.’ And I’ll ask, ‘did you change your bra?’”
Anyone experiencing breast pain can contact Cuda directly, Ellis said. “We can do a work-up. We rule out the dangerous stuff.”
