Navigating Cancer During a Pandemic

October 18, 2021

Up until 2018, Carole Puls received her recommended annual mammogram without fail. She started receiving annual screenings at the age of 30 after a benign lump had been found and removed at age 29. So, when she missed her appointment in 2019, she wasn’t worried – she expected to get an “all clear” result like she had for so many years prior.

“I got busy like so many people do, and I missed my appointment and never got around to rescheduling it,” said Carole. 

But in February 2020, her routine mammogram identified calcifications that her doctor wanted to have biopsied, and she subsequently learned those calcifications were an atypical cell called flat epithelial atypia (FEA), which over time could become breast cancer if they were not removed. 

She was scheduled to meet with a breast surgeon to discuss removing the atypical cells in March, the same time COVID-19 cases began to spike across the country and healthcare providers began postponing non-emergency or elective procedures. Carole was no exception. Her surgeon called to postpone her consultation.

“My surgeon said he had reviewed my biopsy results and felt confident that we could wait a few months,” said Carole. “At the time, there was so much unknown about COVID-19, and even though I was anxious to get it taken care of, I understood.”

When Carole finally met with her surgeon in June, she underwent another biopsy, mammogram and MRI to see if anything had changed since February. Her doctor called soon after with news that Carole was not expecting: The second biopsy identified high-nuclear-grade ductal carcinoma in situ (DCIS) – a non-invasive, early-stage breast cancer.

“I was completely shocked when I learned I had breast cancer,” Carole said. “But my doctor assured me that because we caught it early through screening, it was very treatable.”

Due to challenges brought on by the pandemic, Carole was not immediately scheduled for surgery but rather put on a waiting list for three more months. 

“It was difficult not to worry that time around,” said Carole. “My mind was racing with questions like would my high-grade DCIS become invasive while I was waiting to have it removed?”

Finally, on August 26, she underwent surgery with bilateral reconstruction. Surgery was followed by 21 rounds of radiation.

Today, Carole is managing the disease by taking a hormonal blocker called Tamoxifen, a medicine that treats hormone-positive breast cancer by blocking the effects of estrogen in the breast tissue. 

Carole’s story is not unique – due to COVID, many patients experienced delays in both diagnosis and treatment. Breast cancer screening rates declined by 87% in April 2020 and still have not returned to pre-pandemic rates. 

To help address this impact on cancer screening rates across the country, the American Cancer Society launched a national “Get Screened” initiative with support from healthcare companies like Roche Diagnostics, Carole’s employer.

A longtime supporter of the American Cancer Society, Roche Diagnostics’ support is paving the way for Indiana health systems to take part in a national cohort with 48 institutions across the country. Through learning communities established by the national cohort, participating health institutions can share best practices to minimize the effects of the pandemic on breast, cervical and colorectal cancer screening, address healthcare disparities and reduce barriers to screening exacerbated by the pandemic.

As someone whose cancer was caught early through screening, Carole understands the power of the “Get Screened” initiative. “It makes me proud that Roche has partnered with the American Cancer Society to help increase screening and alleviate the inequities we see in cancer disparities,” she said. “I am proof that early detection through screening can save lives.”

Learn more about Roche Diagnostics’ commitment to fighting breast cancer in the United States.

This article originally appeared in the Indiana Business Journal.


Carol Puls