Michelle Rock might have been in jeopardy had she waited to undergo her first mammogram at 40, the age when screenings for women considered to be at low risk of developing breast cancer are covered by health insurance.

It was a self-examination at 36, one that detected the lump that led to a bilateral mastectomy, six months of chemotherapy and 33 rounds of radiation therapy, that saved the life of the mother of three.

“You may not always find something in a self-exam,” said Rock, a Butler Township resident and a faculty member at Butler County Community College. “But I am a prime example that if I hadn’t found it on my own, things may not have turned out quite so well.”

Melissa Philson is a fellow BC3 faculty member and mother of two from Greenville whose son had nightmares about her dying upon being told of her diagnosis, one that resulted in a bilateral mastectomy and three months of chemotherapy.

Amber Barger is a BC3 registered nursing student and mother of two from Butler who has assisted patients in an oncology unit for 20 years. She wept for weeks after detecting a lump at age 36.

About 42,000 women in the United States die from breast cancer each year, and 75% of women diagnosed with the disease have no known risk factors, according to the Pennsylvania Breast Cancer Coalition.

In the past four years Govs. Tom Wolf and Josh Shapiro have signed legislation that reduced, then eliminated insurance costs for procedures such as magnetic resonance imaging, ultrasounds and genetic testing incurred by residents considered to be at high risk of developing breast cancer.

Rock, Philson and Barger stress the importance of self-examinations, particularly for females younger than 40.

“As soon,” Rock said, “as they become young adults.”

While Philson’s lump was detected through the third mammogram she had received after age 40, “Everyone else I know found theirs from self-checks.”

Self-checks, Barger said, “are important because you get to know your body. So you will know if what you are feeling is abnormal. If it is, you can go to your doctor and they can jump on the ultrasounds and the mammograms and the MRIs.”

An MRI — magnetic resonance imaging — is the “absolute best,” said Natalie Kopp, communications director for the Pennsylvania Breast Cancer Coalition.

“It is two times more effective than a 3D mammogram, particularly in women who have dense breast tissue, which can hide breast cancer on a mammogram.”

Prior to Wolf signing Act 52 of 2020, “We were getting calls here from women saying ‘I got a bill for my MRI that was $4,000, so I am not going to get an MRI any more. I am going to just keep getting my mammogram,’” Kopp said. “We couldn’t have that happen, knowing that an MRI is truly the best detection for women at high risk.”

Act 52 required insurance companies to cover additional screenings, such as an MRI or ultrasound, for women with very dense breast tissue or for those at an increased risk for breast cancer, Kopp said.

“But women still had to pay for deductibles, co-pays and co-insurance out-of-pocket,” Kopp said.

Act 1 of 2023, signed by Shapiro, “eliminates all costs,” Kopp said.

Barger, 44, has been employed for two decades as a certified medical assistant with Allegheny Health Network, where she helps cancer patients to examination rooms or to chemotherapy treatments, draws blood, takes vitals and answers questions about hair and eyebrow loss.

She scheduled an appointment with her physician after experiencing pain and finding a lump in 2017.

“From there, they ordered a mammogram,” Barger said. “They also did an ultrasound. And within a week or two, I had a biopsy.”

Barger’s lump proved to be benign.

“And then I had to have mammograms every six months for a couple of years,” she said.

Rock, 45, has been an instructor in BC3’s Shaffer School of Nursing and Allied Health division for five years. Philson is a psychology professor in the college’s education and behavioral sciences division.

Rock met with her physician after detecting a lump in 2014.

“The first thought that came to mind was, ‘It can’t be cancer. I am too young,’” Rock said. “When I went to see my doctor, he kind of had a similar response. He still ordered the follow-up tests. He said he wasn’t too worried. And I think that was because of my age.”

Rock was diagnosed with ER/PR-positive, HER2-negative Stage 2B breast cancer.

“Everybody was stunned,” she said.

‘Know your body’

Philson, 52, was diagnosed with ER/PR-positive, HER2-negative Stage 1 breast cancer in 2017 at age 44. She will recommend early screenings to her 20-year-old daughter and help BC3 students to raise funds in October — Breast Cancer Awareness Month — to benefit the Glimmer of Hope Foundation, Wexford.

The nonprofit organization funds innovative programs, treatments, technology and research to prevent breast cancer from advancing.

For women younger than 40 and not considered to be at high risk of developing breast cancer, the best practice, Kopp said, is to perform monthly self-examinations.

“If you are a young survivor, self-examination is most likely how you found your breast cancer because you are not of age to get a mammogram yet,” Kopp said.

“Know your body. Know when something doesn’t feel right. Be your own advocate.”

Bill Foley is coordinator of news and media content at Butler County Community College.