By Dave Schafer

Cancer grew in Deloris Castillo’s breast, but she didn’t know it.

Castillo was shy about her body and uncomfortable with the notion of a stranger touching her breasts during an exam. There was no history of cancer in the family, and she didn’t carry any risk factors. So, like many Hispanic women of her generation, she skipped her annual mammograms.

Even after she found a lump, she resisted getting a mammogram, instead relying on her doctor’s diagnosis. The lump was just a fatty buildup, he told her after examining the breast with his hand.

Only when it was the size of a baseball and visible under her blouses did Castillo go for a mammogram.

By then, it was too late.

The lump had consumed tissue and nerves, becoming a part of her. The best hope, doctors said, was for Castillo to undergo chemotherapy to shrink the tumor. Then they would be able to remove the lump, or, at worse, the breast.

The cancer acted faster than the treatment. Castillo, 59, died within eight months.

Her death devastated her family, including Thelma Guevara, an administrative assistant in Human Resources, and their sister, Alice Perez.

Perez was so distraught that she denied anything was wrong when a rash blanketed her chest and her left breast became heavy and deformed. She ignored the pain and, like her sister, the recommended screenings.

Cancer had now struck both of Guevara’s sisters. One waited until it was too late, and the other seemed intent to do the same.

An early advantage
“Cancer’s very curable if it’s caught early. It is very uncurable if you leave it,” said Dr. Dixie Melillo of the Rose Breast Imaging Center in Pasadena and founder of The Rose, a nonprofit breast health care center providing cancer screening, diagnosis and support to women regardless of their ability to pay.

Black and Hispanic women are diagnosed with more advanced tumors than white women. Often, this is because members of those groups don’t get their annual breast cancer screenings. (See graph.)

Also, researchers are seeing more cancer in women 20-30 years old, Melillo said. Because those women assume they’re too young for cancer, they don’t get checked until the cancer has advanced.

“That’s a big mistake,” Melillo said. “You can’t ever ignore a lump. That would be foolish.”

By the time a tumor can be felt, it has been in the body seven to 10 years, Melillo said. A mammogram can see a tumor three to four years before it can be felt.

“The most important time to catch breast cancer is before you can feel it,” Melillo said. “It may not be curable by the time you feel it. If you’ve got a process that is going to help you, you might as well use it.”

Members of the city’s BlueCross BlueShield of Texas plans get their annual mammogram free with their well-woman visit starting at age 40.

During a mammogram, a radiologist positions the breast in the mammography unit. The breast is placed on a special platform and compressed with a paddle made of clear Plexiglas or other plastic.

Low-dose X-rays are used to image the breast. The amount of radiation is about the same as a person receives from background radiation in three months.

Most experts recommend women get a mammogram annually beginning at 40. Melillo said she recommends starting at 35, unless risk factors are involved or a family history of cancer. Then, she recommends starting earlier.

Unfortunately, 26.6 percent of women who had commercial health insurance did not receive a mammogram in 2004, according to the National Committee on Quality Assurance. That was nearly a 2 percent increase from the year before in the number of women ignoring an important screening.

“That’s too high a number,” said Theria Malone, manager of BlueCross BlueShield of Texas’ Quality Improvement Programs. “Women seem to be focused on their family, their work, their home. They need to take time for themselves so they can be here for all those things.”

Many women avoid mammograms because they fear they hurt, Melillo said.

“That is a myth. For most people, it does not hurt at all. Some people are more sensitive, and if they are, there are things that can be done. Especially with the new machines,” she said.

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