Patient Perspective – What Happens during a BRA Consultation?

In a life full of unknowns, St. Mark’s Hospital Women’s Diagnostic Center is empowering women to know their risk and develop a personalized breast cancer screening plan.

Hi, I’m Doctor Kathleen O’Neil,Medical Director of St.  Mark’s Woman’s Diagnostic Center. The Breast Risk Assessment, or BRA initiative at St.  Mark’s, is a program to help woman understand their own risk for breast cancer,and to develop a personalized breast cancer screening plan tailored to those risks, and also based on their own preferences for screening.

One of my concerns in recent years has been about the increasing confusion regarding when woman should have screening mammograms, and it became more and more of a worry for me because I did not want woman to sacrifice, potentially sacrifice, breast health because there was this confusion in the medical community, in the media. And so I wanted to try to come up with something that could help answer question for people and help them learn about themselves and their own breast risks, or their breast health. And it felt right, it felt like we might be able to help people.

My name is Martha Gamble. I’m 41 years old. I’m a Nursing Supervisor at St.  Mark’s Hospital. And prior to the BRA consultation I have never had a mammogram. So, I first heard about the BRA consultation via email, which I quickly deleted and said,”I have no interest  whatsoever. “Mainly because woman’s health is stigmatized with all the terrible things. It’s uncomfortable. It’s embarrassing. I think woman are sometimes hesitant to come in for a mammogram because they may be afraid of finding something. I was thinking, you know, really, was in the back of my head, maybe I need to do this as a responsibility to my family, to myself, to my creator that I live the life that I’m purposed to live.

And so reluctantly I responded to that email that was still in my trash. And I will never forget Marjorie who was my tech. And Marjorie took me into the room and she explained the procedure, and I think her professionalism and her calm really gave me a sense of calm, and I trusted her. And I remember thinking, “How can I trust her already. “But I really did. So, we went into the procedure room, she explained to me what was gonna happen, and I have to tell you it was no big deal. It was great. It was great, and as far as, nothing invasive,nothing painful, nothing supremely embarrassing. It was okay. And she spoke to me the whole time, which actually helped to relieve my nerves a little bit.

A BRA appointment is very different than a regular screening mammogram appointment. This appointment involves a mammogram, yes, but it involves much, much more than that. In terms of building a picture of each woman and her history, and her risk, and helping develop potentially a lifelong plan for breast screening. It is not a cookie cutter plan. It is not based on one size fits all.

In fact, our goal is to move away from the one size fits all approach and build plans that are unique. Unique to every woman and that can changeas her life history changes. – So she brings me to the back room  and she shows me the images, and from the images she explains what she had seen and what my risks were. There was ample time for questions. I didn’t feel rushed at all. It was very informal. It really was comfortable.

And I felt, going back to that initial stigma that we had talked about, I felt comfortable and in charge and in control of what I was going to do. And in an environment where woman are constantly being told, are you nursing? Are you not nursing? Are you having your pap smear? Are you not having your pap smear? Are you gonna do a mammogram?Are you not gonna do a mammogram?Do the mammogram. It was no big deal. It was really a nice experience. And because my risk was lower than averageI don’t have to come back till I’m 45. And that also was a choice. They gave me the option of coming back yearly,or coming back every few years, or coming back at 50,and I said, “You know what?”This was pleasurable enough, I’ll see you in four. “. My advice for woman who are unsure of when to start screening mammograms is to schedule a BRA consultation at St.  Mark’s Woman’s Diagnostic Center.