Komen Missouri Community Partner: SSM Breast Care: Empowering and Engaging Women


Susan G. Komen Missouri community-grant funding allows SSM Health Care’s SSM Breast Care: Empowering and Engaging Women program to provide care to patients who are low income and underinsured. Funding from Komen Missouri also helps the program aid male patients, who are often overlooked.

The Nurse Navigators and Project Coordinator for SSM Breast Care help patients through different types of care, including screening mammograms, diagnostic mammograms and breast health services and consultations.

“It takes a team to make SSM Breast Care successful,” says Tammy Hamma, project director. “Each of our roles plays an integral part in making this program possible.”

Tammy says she has a “direct responsibility to Susan G. Komen Missouri to ensure we are being good stewards of the funds we are given and that we are meeting the goals for the year. This program enables us to spread the inspiring Komen story and to emphasize the vital importance of annual screening mammograms in order to aid in early detection.”

The program educates women in the community to be their own greatest advocates for breast health.

Tammy recalls a young woman in St. Charles County with no insurance who was cared for recently by an SSM Breast Care Nurse Navigator. This young woman was caring for her mother, a Komen Missouri-funded patient battling breast cancer. In her mother’s final days, the young woman discovered a breast lump and promised her mother she would have it checked. The day after her mother’s funeral, the daughter called a Nurse Navigator at SSM Breast Care and received help and guidance through diagnostic procedures.

Fortunately for this young woman, the lump was benign, and she is now on a high-risk screening schedule to detect any other issues early.

“SSM Health Care has had the privilege of being partners with Susan G. Komen Missouri for 14 years,” says Tammy.

Susan G. Komen Missouri’s community grants help fund local breast cancer screening, breast health education and patient navigation and support services for those in our community who otherwise may not have access due to low income, lack of insurance or other barriers.


Komen Missouri Community Partner: Mercy Health Foundation of St. Louis’ Breast Cancer Screening and Education Program


The Breast Cancer Screening and Education Program at Mercy Health Foundation of St. Louis works with community agencies to help identify and schedule uninsured and underinsured, low-income women for breast screenings.

The program provides free mammograms and clinical breast exams, and educates about breast self-awareness at Mercy Breast Centers and in local communities through a mammography van. During screening events, a Nurse Navigator/Nurse Practitioner provides clinical breast exams, educates and provides care.

Angela Ruppel, the program’s project director and manager, explains that Susan G. Komen Missouri, “provides funding for mammograms and breast health services, clinical breast exams, breast self-awareness education and the availability of a mammography van and Nurse Navigators/Nurse Practitioners to assist and coordinate care for the uninsured and underinsured women in the community.”

Angela recalls a patient referred to the program who was “an uninsured 33-year old…single mom raising two children, working part time and going to school full time.”

The patient discovered a lump and was scheduled for a breast exam by Nurse Navigators/Nurse Practitioners, and then had a diagnostic mammogram and ultrasound.

“Due to this program and generous funds from Komen Missouri, the patient was able to have her diagnostic testing completed, which showed two solid masses,” says Angela.

The patient was scheduled for a consultation and had a breast biopsy. She was positive for invasive ductal carcinoma, underwent a double mastectomy and breast reconstruction. Angela says this woman “now has continued with her schooling and has hope for the future for both her and her family.”

This is the 13th year of Komen Missouri funding for this program.

Susan G. Komen Missouri’s community grants help fund local breast cancer screening, breast health education and patient navigation and support services for those in our community who otherwise may not have access due to low income, lack of insurance or other barriers.

Statement from Susan G. Komen®: Women and Healthcare Providers Should Have the Final Say on Mammogram Schedules

Susan G. Komen® shared this statement regarding breast cancer screening:

Komen Renews Concern over Task Force Proposal to Raise Routine Mammography Age

DALLAS – Jan. 11, 2016 – The leader of the world’s largest breast cancer organization says women and their doctors should be the final decision-makers when it comes to breast cancer screening, and that screening tests, if recommended by a healthcare provider, should be covered by insurers and government regardless of a woman’s age.

The comments from Susan G. Komen President and CEO Dr. Judy Salerno came in response to U.S. Preventive Services Task Force (USPSTF) recommendations, issued today, that would raise the recommended age for the start of routine mammograms from 40 to 50 for women of average risk. USPSTF issued similar recommendations in 2009.

These latest recommendations would not be implemented immediately due to a two-year moratorium imposed by Congress.

Nevertheless, Salerno said Komen is concerned that these recommendations could effectively bar access to screenings for millions of women under 50 because third party payers often use USPSTF recommendations to decide whether they will pay for certain tests.

“A lack of coverage would be most harshly felt in high-risk and underserved populations,” she said, “African-American women, for example, are often diagnosed at younger ages with aggressive forms of breast cancer – and die of breast cancer at rates over 40 percent higher than white women. Screening at younger ages is a critical tool for these women.”

“The medical field is moving toward determining individual needs for screening based on a woman’s risk,” she said. “Rather than establishing higher age-based standards that create potential barriers to care, women should be able to make informed decisions about breast cancer screening, develop a schedule that is right for them with their healthcare provider, and be assured that the screenings they need will be paid for.”

Salerno encouraged increased investment in research to develop better screening tools. Komen has funded more than $33 million to find more precise early detection methods such as blood and tissue tests. “Until those are available, mammograms are the most widely available and cost effective test that we have, and women and their healthcare providers should have access to them,” she said. Information about breast cancer risk is available on komen.org.

Your Support Gives Strength


Guest Writer: Helen Chesnut, Susan G. Komen Missouri Executive Director

Susan G. Komen® Missouri was founded in 1999 by dedicated volunteers fueled by a promise to save lives and end breast cancer forever. It started with our inaugural Race for the Cure in St. Louis, attracting more than 10,000 survivors, co-survivors, families and friends and raising over $300,000.

Since then, our impact on the local fight against breast cancer has been strengthened by year-round supporters – people who share our commitment to meeting the breast health needs of the women, men and families most at risk and most in need right here in our community.

Thank you for the role you play in supporting your local Komen Affiliate as we focus every day on our mission to save lives and end breast cancer forever. Your support gives strength to individuals and families – like Jeremy’s – in our community.

Jeremy Harmon’s family member found a lump in her breast at age 36 and, out of concern, she had it removed. Although it was not cancerous, as a result of the diagnosis she will now need to have an annual mammogram. This experience spurred Jeremy to take action in the fight against breast cancer.

“While our family is grateful for the outcome,” he said, “the potential impact opened my eyes to my desire to be more involved in the cause in some manner.” Jeremy is now one of our Pink Tie Guys, serving as a partner in the promise to save lives and end breast cancer forever.

Knowing that we can help families like Jeremy’s, empowering them to take charge of their health and inspiring them to take action every day, gives me strength. Your contribution will help give strength to hundreds of lives through the programs supported by our local grants.

Right now, our funding supports seven local organizations that deliver critical, lifesaving breast health services – including free mammograms and navigation through the health care system. Right now, Komen-funded researchers in St. Louis are investigating the growth of breast cell types that contribute to breast density and therefore may impact breast cancer risk.

Because breast cancer knows no boundaries and never takes a day off, I’m asking you to help continue to fight this disease by contributing to our 2015 Holiday Giving Campaign today. Through the consistent and valued support of donors like you, we are able to make a difference in the screening, care and survival of women, men and families in our community.

Your gift today could help us reach our Campaign goal of $30,000. This could provide funding for 300 mammograms or more than 1,300 hours of patient navigation. Please make a one-time or monthly donation today.

I thank you for your support!

Statement from Susan G. Komen®: Women Should Have Access to, Coverage for Mammography

Susan G. Komen® shared this statement regarding breast cancer screening:

World’s Largest Breast Cancer Organization Reiterates that Screening Should Be Based on Individual Risk and is Decision for Women and their Health Care Providers

DALLAS – Oct. 20, 2015 – The Susan G. Komen® breast cancer organization today said that all women should have access to regular mammograms when they and their health care providers decide that it is the right time for screening based on individual risk for breast cancer, and that the screening tests should be covered by third-party payers such as insurance companies and government programs.

Komen’s statement came following the release of new American Cancer Society (ACS) screening guidelines, published today in the Journal of the American Medical Association (JAMA). In the guidelines, ACS raised its recommended age for annual screening mammograms from 40 to 45 for women of average risk for breast cancer, with biennial mammography for women 55-74. The U.S. Preventive Services Task Force (USPSTF) also has drafted guidelines that would raise the recommended age for regular mammography to 50 for women of average risk.

“We have a great deal of respect for the ACS and the USPSTF, their expert committees and their thorough review of the scientific literature to inform the current guidelines. Although guidelines may differ regarding the age at which routine screening should begin, there is agreement that mammography is the best available tool for detecting breast cancer and that women and their health care providers should decide when those screenings should begin for individuals,” said Dr. Judy Salerno, President and CEO of Susan G. Komen.

Salerno said that the continuing debate over the timing of mammography fails to address several important issues.

“First, the medical field is moving toward determining individual needs for screening based on a woman’s risk, such as family history of breast cancer. Ultimately, women must have better and more accurate information about their individual risk for breast cancer so that they and their providers can make informed decisions about the screening schedule that is right for them. Knowledge is power,” she said. Information about breast cancer risk is available on komen.org.

“Second, it is estimated that about one-third of women who should be screened do not access these services. This means that we must take all steps necessary to ensure that women don’t face economic or other barriers when their health care providers recommend screening. It’s well established that early detection, combined with effective treatment, reduces mortality from breast cancer.”

“Third – and this is a point we’ve made often – we absolutely must continue to invest in finding screening methods that are more accurate, cost-effective, easy-to-administer, and more widely available than mammography,” Salerno said. Komen has invested more than $33 million to date into research to find better screening technology for breast cancer, such as blood and tissue tests.

The ACS recommendations are not binding on health care providers or payers, Salerno noted, “but we are concerned that they have the potential to lead to reduced accessibility to and coverage for health screenings from both private and public insurers.”

In addition to its new recommended screening ages, ACS said clinical breast exams – the manual palpation of the breast and axilla (underarm) by trained health care providers – are no longer necessary as they did not reduce mortality from breast cancer and because better screening tools, such as mammography, are available. Clinical breast exams are usually conducted during routine “well woman” doctor visits, often beginning when a woman is in her 20s.

“As a practical matter, clinical breast exams take very little time, are not invasive, and may be the only form of breast screening available, especially in rural areas and for younger women who are not at an age when regular mammography would be indicated,” Salerno said, adding that more information is needed on the efficacy of clinical breast exams.

Salerno said Komen and its scientific advisors will closely review the ACS recommendations, including mammography and clinical breast exams.

She acknowledged concerns about “overtreatment” for breast lesions or tumors that are found early but might not develop into cancer. “This is a real issue, but one that also requires education, so that women can have discussions with their health care providers about the course of cancer treatment that is right for them. And more research is needed to help determine which women may go on to have invasive cancer.  A woman cannot make a decision about treatment, however, if she hasn’t been screened.”

Komen also is investing in research that would allow health care providers to accurately differentiate between breast lesions that will become cancerous, and those that won’t.

Breast Cancer Survivorship: Post-Diagnosis

2015KomenNCR-NBCAMGraphicFaceookCover-SurvivorshipBreast Reconstruction

Breast reconstruction can help restore the look and feel of the breast after a mastectomy. Performed by a plastic surgeon, breast reconstruction can be done at the same time as the mastectomy (“immediate”), or at a later date (“delayed”). Many women now get immediate breast reconstruction.

However, the timing depends on your situation and the treatment you will have after surgery. Not all women can have immediate reconstruction. It is important to discuss your options with your plastic surgeon, breast surgeon and oncologist (and your radiation oncologist if you are having radiation therapy).

There is no one best reconstruction method. There are pros and cons to each. For example, breast implants require less extensive surgery than procedures using your own body tissues, but the results may look and feel less natural. However, there are fairly few complications with any of the current techniques, especially when a woman is properly selected for a procedure.

Most breast reconstruction methods involve several steps. Both immediate and delayed reconstructions require a hospital stay for the first procedure. However, follow-up procedures may be done on an outpatient basis.


Breast cancer survivors have an increased risk of getting a new breast cancer compared to those who have never had breast cancer. That is why it is important to get the follow-up care your doctor recommends. With proper follow-up, your doctor can keep track of how you are doing. This includes checking for and treating side effects. Follow-up care can also help ensure any recurrence of breast cancer can be found early when treatment is most effective.

The National Comprehensive Cancer Network offers these guidelines for follow-up of breast cancer treatment:

  1. Have a mammogram every 12 months. (For women treated with lumpectomy, have a mammogram six months after radiation therapy ends, then every 12 months.)
  1. Have a physical exam every three to six months for the first three years, every six to 12 months for years four and five, then every 12 months.
  1. Have a pelvic exam every 12 months if taking tamoxifen and have not had the uterus removed (have not had a hysterectomy).
  1. Have a bone health exam every one to two years, depending on a person’s risk factors.

Follow-up Tests

Depending on the symptoms, blood tests (including tumor marker tests) and imaging tests (including bone scans, CT scans, PET scans and chest X-rays) may be used to check for metastases. Using these tests to check for early metastases in people with no symptoms of metastases does not increase survival. For people with no symptoms of metastases, blood and imaging tests (other than mammography) are not a standard part of follow-up care.

Learn more about medical care after breast cancer treatment: http://ww5.komen.org/BreastCancer/MedicalCareAfterTreatment.html

We are celebrating National Breast Cancer Awareness Month. Connect with and follow Komen St. Louis and use #Komen365 to join in the conversation.

Breast Cancer Education: Mammograms

2015KomenNCR-NBCAMGraphicFaceookCover-GeneralMammography is a screening tool that uses X-rays to create images of the breast. These images, called mammograms, are used to find early signs of breast cancer such as a dense mass or clusters of calcium.

Mammography is the best screening tool for breast cancer used today. It can find cancers at an early stage, when they are small (too small to be felt) and the chances of survival are highest.

X-ray images of the breast can be captured on film or stored directly onto a computer (digital). Film and digital mammography are similar in their ability to detect breast cancer. Because digital images are viewed on a computer, they can be lightened or darkened, and certain sections can be enlarged and looked at more closely. This ability to control the images on a computer makes digital mammography more accurate than film mammography for some women. And, because the images are stored on a computer, they can be shared more easily with another radiologist for review.

Guidelines for people at average risk vary. Most major cancer organizations recommend that mammograms begin at age 40 for women who are at average risk for breast cancer.

Women who are at a higher risk for breast cancer should speak with their doctor about when and how often they should get screened. Some women ages 70 and older may stop regular screening. Susan G. Komen recommends that women who are in good health and could benefit from treatment (if breast cancer were found) should continue to get mammograms.

At any age, if there is any question about whether you should have a mammogram, talk to your health care provider.

Learn more: http://ww5.komen.org/BreastCancer/Mammography.html

Learn more: http://ww5.komen.org/uploadedFiles/_Komen/Content/About_Breast_Cancer/Tools_and_Resources/Fact_Sheets_and_Breast_Self_Awareness_Cards/Mammography.pdf

We’re celebrating National Breast Cancer Awareness Month for the next six weeks. Connect with and follow Komen St. Louis and use #Komen365 to join in the conversation.