For newly-diagnosed breast cancer patients, one of the toughest challenges is navigating today's complicated health system at a time of emotional turmoil. It can be hard to find the right doctors, understand the treatment options, make appointments and be sure that information goes to the right places.
Breast cancer survivor Renee Messalle, a 43-year-old mother in Arlington, Va., knows just how important coordinated care is to patients. Her story illustrates the national need to bring health care's many "moving parts" more closely together in order to improve the patient experience.
Two years ago, Messalle found a small lump in her breast. "Something caught my eye one morning and I saw a dimpling," she says. Messalle wasn't overly concerned, though, since she had gotten a clean bill of health at a mammogram screening six months ago and had no family history of breast cancer.
When Messalle saw her OB-GYN specialist in early January for a regular appointment, she mentioned the lump in her breast. Her doctor was concerned and made an appointment for the next day for a mammogram and ultrasound, and also scheduled an appointment with a breast surgeon to look at the results.
After testing showed Messalle had a 3.5-cm cancerous tumor, she met with the breast surgeon to discuss the next steps. Fortunately for Messalle, her surgeon was part of the Inova hospital system, and she was immediately assigned a breast cancer navigator, who arranged for genetic testing to determine the nature of the tumor, as well as an MRI scan, and scheduled the surgery and laboratory tests needed prior to surgery.
"I was in shell shock with all that was happening, and having a coordinator who knew what steps to take and provided help along the way was a huge relief for me," Messalle says. Even better, the genetics lab, MRI center and hospital laboratory were able to upload their results to Messalle's electronic medical record (EMR) in the Inova system, so her cancer surgeon could see all the relevant information.
Three weeks after her diagnosis Messalle had both breasts removed and chest expanders were implanted by her surgeon. Because cancer cells were found in three of her lymph nodes, Messalle also went through several months of chemotherapy and radiation therapy.
When Messalle made a series of appointments with a plastic surgeon outside the Inova system for her final reconstructive surgery, things were not as well coordinated. "My plastic surgeon was very good, but once I left the left the network, several things fell through the cracks," she says. "For instance, I had to rush to the laboratory for some last-minute pre-surgery tests because they couldn't find the information. Things felt much more chaotic."
As the nation marks Breast Cancer Month in October, it's important to recognize the importance of providing well-coordinated care to all breast cancer patients so no one "falls through the cracks" in the system and that patients get expedited and seamless service. On a personal note, I lost a dear family friend to cancer because she didn't receive the right care at the right time.
Meanwhile, things are going well for Messalle, who celebrated her one year cancer-free anniversary on Oct. 3. "I had an aggressive form of breast cancer, but my outlook now is very positive," she says. "I've become a big believer in breast self-exams as well as mammograms. If I hadn't noticed the lump for another year, it might have been too late for me. So don't take chances. If you see something unusual, call your doctor right away."
Note: Every patient faces a different situation, and this blog is not meant for medical advice. If you would like more information on breast cancer screening, visit the National Cancer Institute's website.
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