Rader Clinic, Belvoir hospital streamline breast cancer detection

Last October, Marcia Flagg, a registered nurse and quality manager tasked with managing 14,000 Andrew Rader U.S. Army Health Clinic enrollees noticed a problem: 700 enrollees, ages 52 to 74, were either overdue or never had a mammogram, a vital tool to screen for breast cancer early, according to Flagg.

Mammograms are used to detect breast cancer in its earliest stages, when treatment has a higher probability of being successful and the disease cured, according to the American Cancer Society.

"Everyone was wearing pink during the month of October, even NFL players were on the field wearing pink gloves and using pink towels to remind people about breast cancer awareness, so women are annually reminded," Flagg said. "But the problem is there's women going about their lives thinking they are healthy who are actually at risk."

Flagg, who has three decades of experience both in nursing and program management, knew a solution was needed. She immediately started an initiative that was twofold: first, she sent urgent letters to 700 patients and partnered with Fort Belvoir Community Hospital's mammography department.

"It would be so much easier if we had the capability to screen these women right here in our facility [Rader Clinic]," Flagg said. "The issue is every extra step that's added is going to increase the percentage of women who are going to delay having their mammogram done."

Secondly, Flagg coordinated with other local area military health treatment facilities with Mammography departments to begin seeing Rader's patients. For the past five months, Fort Belvoir Community Hospital's Mammography Department has accepted referrals from Rader Clinic to help screen the hundreds of patients overdue for mammograms. But patients have also been referred to Walter Reed National Military Medical Center and Kimbrough Ambulatory Care Center at Fort George G. Meade.

Meanwhile, Flagg has continued her letter campaign and referrals to encourage women to seek mammograms.

"Fort Belvoir has been committed to squeezing in our patients because they know how important it is," Flagg said. "Numbers have changed slightly, but we are still in the red for breast cancer screenings and that's not where we want to be."

The American Cancer Society recommends women ages 45-54 should receive a mammogram every year; every two years for women over 55.

The society's recommendation suggests the number of patients enrolled at Rader Clinic at risk could be far higher. The initial batch of letters to some 700 women last October didn't include women who were ages 45 to 51, so there could be many more women who are overdue for mammograms, Flagg said.

JBM-HH family member recently tested positive for breast cancer

Less than two months into Flagg's breast cancer screening initiative, a spouse who was preparing to change duty stations with her husband tested positive for breast cancer.

"This … patient had not been to the doctor for five years," said Yaelmie Gomez, an Exceptional Family Member Program coordinator and overseas suitability screener for Rader Clinic. "So this lady needed a physical, a pap smear and a mammogram. Following two biopsies … she was diagnosed with two types of cancer."

The diagnosis was severe enough to warrant immediate radiation treatment, she said.

In addition, two other patients who were overdue for mammograms had biopsies that came back benign, Gomez said.

"Hopefully we helped save a life by catching something that could have gone uncaught had it not been for Ms. Flagg's initiative and the collaboration with Fort Belvoir Community Hospital," Gomez said. "But it also reiterates that it is important to stay current on your health."

Flagg and Gomez both remind patients that self-care needs to be a priority, especially when it comes to potentially life-saving screenings and tests. Some military spouses simply do not pay enough attention to their own health, a hard lesson that plagues the military spouse population in the region, according to Gomez and Flagg.

"A lot of times I see the dependent population is being too much of a caregiver and forgetting about taking care of themselves," Gomez said. "There's basically a lack of information and the false belief that they are 100 percent healthy, especially if there isn't a history of breast cancer in their family."

Flagg reminds women age 40 and over about the importance of early breast cancer screenings. Patients interested or in need of a mammogram should call 703-696-3216. Flagg will arrange the date patients visit Fort Belvoir Community Hospital; the hospital accepts Rader Clinic referrals for appointments scheduled Mondays through Fridays at 1 p.m. or later.

Flagg said mammograms should take 15 minutes to complete, but do require patients to follow strict instructions beforehand, such as not wearing deodorants, powders, lotions or creams on breasts/underarms prior to the exam and not to bring children to the appointment.

Regardless of any perceived inconvenience by patients, annual mammograms are critical to preserving women's health, she said.