PEORIA — Lori Farris’ box of educational materials contain two simulated breasts.
One is clear, allowing her patients to see lumps hidden deep in the silicone interior. The other is opaque so patients can discover lumps with their fingertips.
Farris is a nurse certified as the MammaCare Clinical Breast Examiner at UnityPoint Health’s new High Risk Breast Screening Clinic at the Atrium Building in Downtown Peoria. The clinic opened early last summer to serve women who are at higher risk for breast cancer, but not experiencing obvious symptoms of the disease. Before the clinic opened, Farris spent two long days at a training seminar learning the advanced technique for breast exams.
“You use the tips of your fingers, the most sensitive part, and you work in overlapping vertical strips down the breast to cover all the tissue,” she said. “You rub in dime-sized circles three times — first light, then medium, then deep pressure to feel all the way to the chest wall.”
Farris can detect tiny lumps and identify the difference between normal breast tissue texture or tissue thickening. She explains the technique to her patients, who have been determined to have a higher risk for breast cancer during their regular annual mammogram screening.
“The first thing I do for my patients is to explain why they are here,” said Farris. “Sometimes they say, ‘I’m confused, my mammogram was normal, why am I here?’ ”
When Manito resident Nancy Roots, 46, had her regular mammogram in October she completed a Tyrer-Cuzick assessment, which determined her risk of developing breast cancer.
“They mentioned to me that they had this High Risk Breast Clinic now, and that they would be giving me a call,” said Roots. Though the words “high risk” scared her, Roots wanted to be proactive — her mother had breast cancer about 11 years ago.
“I ended up giving them a call before they had a chance to call me,” she said.
During that first phone call with Farris, Roots answered questions on a longer version of the Tyrer-Cuzick risk assessment. In the end, she scored higher than she had at her mammogram appointment.
“Initially my percentage was 17, but when I spoke to Lori she asked me additional questions and my score came to 27 percent,” said Roots.
Women who score 20 percent or higher are referred to the High Risk Breast Screening Clinic, said Farris. Survey questions include family history, age at first period, age at first delivery, and age at menopause. Other factors considered are if the patient ever used hormones, like birth control, if they have had past cancers, or if they are a carrier of the BRCA1/2 gene mutation.
Once women get to the High Risk Breast Screening Clinic, they are given a thorough exam and sometimes referred for further testing, which clinic staff helps set up.
“We’re finding people who have symptoms, even if they’ve had a normal mammogram, like nipple discharge or an inflamed breast node," said Farris. "In the old days, you had a mammogram and it came back normal and that was it. Now, if you have risk factors, like dense breasts, we investigate that.”
Farris sees about five clients a week. In addition to diagnostics, she also counsels patients on prevention.
“Since they already know they are at increased risk, we talk about cancer reduction, all the things they can do to boost the immune system, like exercise, drinking less alcohol and healthy eating,” said Farris. She also advises patients to avoid drinking from plastic bottles not labeled BPA free, and to get plenty of fresh air.
“If you spend more time outside, you will increase your vitamin D levels — low levels have been linked to cancer,” she said.
The first time Roots and Farris met face to face during an appointment they discussed Farris’ mammogram results, which were suspicious. Roots was referred for further testing.
“I came home from my first appointment and I told my husband ‘I don’t know what’s going on, but I feel like they are all on my side, and I can face whatever is ahead of me,’ ” she said. “I had never been in an office where I felt that much support.”
Tests revealed a non-cancerous growth, which could have become cancerous in the future, said Roots. The mass was removed. One of the many screenings Roots had was a genetic test where she learned that she doesn’t have the BRCA1/2 gene mutation. It was a great comfort, considering her family history.
“The genetics nurse said she didn’t feel my daughters would be at risk,” said Roots.
Though she’s been given a clean bill of health, Roots is now on a more vigilant screening routine, with exams every six months. From mammogram to lump removal, Roots’ experience lasted about six weeks. Though it was scary, she describes the experience as positive.
“I just wish this would have been around when my mother had breast cancer. The level of care, the technology, the stuff they can do now is just so amazing.”
Leslie Renken can be reached at 686-3250 or email@example.com. Follow her on Twitter.com/LeslieRenken, and subscribe to her on Facebook.com/leslie.renken.