Connie Smith wasn’t due for her annual mammogram until October. But in March, she found a lump during her monthly breast self-exam, which she has conducted ever since a cancer scare in 1995.
Despite having worked all of her life for major corporations, Smith’s health benefits were about to expire. “I was almost more worried about not having insurance than about having breast cancer,” said the 62-year-old Baltimore resident.
While at MedStar Harbor Hospital for a colonoscopy, Smith was relieved to learn about the Baltimore City Breast and Cervical Cancer Program (BCCP) for the uninsured and underinsured.
Support and Reassurance
Shirley McKnight, RNC, BSN, case manager for BCCP, assured Smith that the program, funded by state and federal funds, would take care of her.
After losing a sister to breast cancer, McKnight has dedicated herself to helping women use BCCP’s many services. McKnight arranged for Smith to have a free screening — a mammogram and a clinical breast examination performed by James Patterson, MD, chief of obstetrics and gynecology at MedStar Harbor Hospital.
As it turned out, Smith needed an additional test — a biopsy. McKnight helped Smith apply for the state-funded Maryland Breast and Cervical Cancer Diagnosis and Treatment Program, which would pay for the surgery and follow-up care.
While waiting to hear back from the state-funded program, McKnight prepared Smith about what to expect next, explaining how MedStar Harbor Hospital coordinates care and tailors an individualized program based on a patient’s needs.
“Shirley is wonderful,” said Smith. “I don’t know what I would have done without her assistance.”
Everything You Need in One Place
After the state-funded program approved Smith, McKnight helped her schedule the biopsy with MedStar Harbor Hospital surgeon Anthony Raneri, MD. And she was there to help Smith after her biopsy revealed she had stage-one breast cancer.
At this time, one of Smith’s sisters who worked for a cancer center at a nearby major hospital urged Smith to switch her care to that hospital.
“I was totally against it,” said Smith, explaining that she appreciated MedStar Harbor’s warm, personalized atmosphere, the kindness of her treatment team, and the efficiency of the process. “Staying with MedStar Harbor Hospital is the best thing that could have happened to me. The program is magnificent. It takes care of everything you could ever need.”
"Patients can seek further treatment from any community provider," said McKnight. “But 95 percent choose to stay at MedStar Harbor. They really appreciate our close-knit group and comprehensive approach.”
Smith certainly did and was grateful for all of McKnight’s support. McKnight introduced Smith to several resources. The Red Devils, a nonprofit organization that provides assistance to Baltimore women undergoing breast cancer care, provided transportation for Smith to get to her radiation treatments. Reach for Recovery, sponsored by the American Cancer Society, contacted Smith and offered its help. The Komen Foundation provided educational materials.
“I can’t give enough credit to MedStar Harbor Hospital and the staff in the Cancer Center. Drs. Jack Hong, and Raneri helped me every step of the way,” Smith said.
Early Detection Is Critical
Program Coordinator Linda Wieczynski, RN, pointed out that finding cancer early is the cornerstone of BCCP. “We want women to come back year after year for screening,” she said. “That way, even the smallest change can be detected as soon as possible.”
With annual testing, microscopic abnormalities can be spotted before they can be felt. Catching cancer early means more breast-sparing treatment options, fewer complications and better outcomes. “When caught early enough, women generally have the option to keep their breast with a lumpectomy — removing the cancer and a rim of normal tissue around it — followed by radiation,” Wieczynski said, adding that mastectomy (removal of the breast) and chemotherapy often are not necessary for breast cancer found during the earliest stages.
Wieczynski, who has been with BCCP since it was founded, explained that the longer breast cancer goes undetected, the greater the chance it will spread from the breast. Once it has traveled through the lymph nodes, into the bloodstream and to vital organs, where it grows and destroys normal tissue — and thus becomes more difficult to treat.
Still, many women are afraid to get screened. “Don’t be frightened; the experience is not as painful as you think it will be. If you’re truly scared, bring a friend or family member with you,” Smith said. “Sitting around and worrying also does not help. And don’t let lack of money or insurance stop you.”
“Ignoring a lump can rarely have a happy ending,” added Wieczynski. “Getting screened before symptoms develop is what early detection is all about.”
Since 2002, BCCP has performed 6,700 mammograms, detecting 41 breast cancers — more than half of which were at stage zero or one, the earliest stages when the cancer was easier to treat.