Mary Lynn Tucker

Mary Lynn Tucker is a registered nurse, yoga instructor and 20-year resident of the lake. She has worked in the field of wellness and health education since 1978 and currently serves on the adjunct faculty at The Jefferson College of Health Sciences.

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With the recent "Pink Parade" in Roanoke and pink ribbons everywhere, it's hard not to know that October is Breast Cancer Awareness Month.

While statistics indicate a decrease in mortality from breast cancer, experts say it is not the result of new treatment methods, but rather the benefit of early detection. One form of early detection is an annual mammogram on women over 40.

Interestingly, a study by the National Cancer Institute found that the number of women in this country ages 50 to 64 having mammograms dropped by 7 percent from 2000 to 2005.

The lake area is blessed to have a breast cancer radiology specialist, Dr. Joel Shapiro, who has lived here since 1986. He and his wife, Norma, moved to the lake from Philadelphia. They were looking for places to retire on the water and fell in love with Smith Mountain Lake.

Norma Shapiro is a stained-glass and jewelry artist whose work can be seen at The Little Gallery, under the name of her business, "L'Chaim!" That means "To life!" in Hebrew.

It seems appropriate to echo "To life!" with Joel Shapiro's work. He started his practice at Bedford Memorial Hospital in 1986, when there were few mammography specialists in Southwest Virginia. He subsequently spent 15 years as the director of Breast Imaging Services at Bedford Memorial Hospital.

He retired in 2001, but has continued his interest in breast cancer as a member of the Professional Advisory Board at Carilion Breast Care Center and chairman of the screening mammography subcommittee for the organization.

"The mission of the Breast Care Center is to decrease mortality from breast cancer, and mammography is the best tool for this," Shapiro said. "Mammography is the gold standard for early detection of the disease, and there is a 90 percent survival rate if breast cancer is detected early. There is no question that mammograms save lives."

So, why don't all eligible women get regular mammograms?

In an attempt to answer that question, the Carilion Breast Care Center conducted a research study.

Shapiro explained: "One of the first things we did was measure the number of eligible women by surveying the Carilion service area. Then we looked at the number of actual mammograms performed, and found that only about one-third of women who should be getting mammograms are actually getting them."

To further understand what interventions by family practitioners might improve this compliance rate, the study compared three different approaches. In one group, the doctor told patients to get mammograms; another group saw a video and brochure presentation from the American Cancer Society; a third group of patients were given mammogram appointments before they left the office.

"We are still analyzing the data from this study, but I can say that we have found significantly better compliance in the group given an appointment in their hand," Shapiro said.

When asked why he thought women did not go for regular mammograms, Shapiro had several possible explanations and debunked the most common excuses:

• "Some women report that their doctor did not tell them to get a mammogram." Shapiro suggested that if your doctor doesn't mention it, you should ask him or her about it and make an appointment. You do not need a physician's referral to schedule a mammogram.

• "Some women state that they don't have a family history of breast cancer, so they don't see themselves at risk. This is erroneous, as very few breast cancers are actually the result of inherited traits."

• "Some women are concerned about discomfort during the procedure. This can be mostly alleviated by scheduling it one week after your menstrual period, when breasts are less tender. Avoiding caffeine also helps, as it has been shown to increase breast tenderness." Also, you can ask if your screener uses the MammoPad, which is a cushioning device.

• "Although some women are concerned about the cost of the procedure, this is not really much of a factor. Most insurance companies cover the cost of yearly mammograms. For those without insurance, assistance is available."

• "Another factor may be that women are so busy taking care of everyone else in the family that they neglect to take care of themselves. It is important to put a priority on taking care of your own health, so that you will be able to take care of your family."

• "For those who might be concerned about exposure to radiation, they should realize that the radiation exposure from a mammogram is about the same as the exposure from flying across the country."

When deciding where to go for a mammogram, Shapiro said training and experience by those giving and reading the mammogram should be considered.

"Be certain that the facility is certified by the American College of Radiology/MQSA and that the radiologists reading the mammograms are specialized in that skill, with training and lots of experience," Shapiro said.

Other procedures for screening include MRI, which is only used in high-risk cases, and automated ultrasound, which is currently being evaluated for screening.

For now, annual mammography is the best tool for early detection of breast cancer and early detection is key to survival.