Lillie Shockney

Lillie Shockney, RN., BS., MAS is the Administrative Director of the Johns Hopkins Avon Foundation Breast Center in Baltimore, MD. Her career has been focused on clinical nursing care with a special focus on cancer patients. Mrs. Shockney was the Director of Performance Improvement and Utilization Management from 1987-1997. After being diagnosed with breast cancer at age 38 in 1992, she began to contribute additional time to the Johns Hopkins Hospital as a volunteer for the Breast Center. In this role, Mrs. Shockney conducted patient satisfaction surveys, developed quality of care measurement methods, and worked with the clinical team to develop ways to improve patient care and services for women diagnosed with breast cancer.

In 1997, she formally joined the Breast Center staff as the Education and Outreach Director, responsible for the quality of care programs, patient education programs, survivor volunteer team, community outreach at a local, regional and national level, webmaster, and patient advocacy. Mrs. Shockney is a registered nurse with a BS degree in Health Care Administration from Saint Joseph's College and a Masters in Administrative Science from the Johns Hopkins University. She is an Advisory Board and Board of Trustee member of the National Consortium of Breast Centers, a member of the National Consumer Advisory Council and was appointed to the Board of the National Women's Health Research Center.

Mrs. Shockney is also on the Medical Advisory Boards of several breast cancer organizations, including the YSC Medical Advisory Board, and a recipient of numerous community service awards. She is a published author on the subject of breast cancer with two books and many articles to her name. Mrs. Shockney is also the co-founder and vice-president of the national nonprofit organization "Mothers Supporting Daughters with Breast Cancer."

Questions & Responses:

Question 1:

Hello, I am looking for some information on lumps. I have a 14 year old girl and she came to me about a lump on her right breast. It is about 2 to 3" above the nipple. She did not know it was there till her little sister hit her there. It is about the size of a 1/2 dollar. Should I take her in ASAP, to see what it is? And who do I send her to? I thank you for your time.

Answer:

It can be scary for a teenager to find a breast lump. Girls learn at an early age about breast cancer and sadly also learn to fear its diagnosis. I think the best thing for you to do would be to take her to your family doctor for evaluation. Usually these lumps fall into one of two categories for girls this age- benign masses called fibroadenomas, or hormonal changes. Since she has also received a recent injury the doctor may opt to do an ultrasound to more accurately diagnose this lump.

Question 2:

Hi, I am 43, diagnosed with DCIS in one breast(10 cm) at 41. I had bilat mastectomies, sentinal node bopsy (frozen sect neg,futher screening showed 8-10 ductal cells) on Tamoxifen. My question is, I had genetic testing as my mother was diagnosed with invasive breast CA -screen was neg. This medical practice was "pushing" the idea of elective removal of ovaries, or hyster, or both. My oncologist does not feel I should pursue this. I am a nurse, and a bit confused. I still get a period, not too crazy about the idea of the surgery. What are your thoughts?

Answer:

The real issue is the rationale behind the recommendation. If they think your family may still carry a gene, one that we don't have a blood test for yet, then their mission in recommending this would be to reduce your risk of getting ovarian cancer. If their purpose however is to reduce risk of breast cancer syetemically (in other organ sites) then think more about this since you are taking tamoxifen already to reduce this risk. There is no harm is pursuing a second opinion. 

Question 3:

Hi, I have a lump which the mammogram can't see and the ultrasound doesn't show as anything. But it is harder and slightly larger than it was 6 months ago. I am scheduled to see a surgeon for a biopsy in a couple of weeks. I haven't lived in Indianapolis IN but a few years. How do I find the best breast surgeon here? Do I just trust the surgeon my doctor is sending me to?

Answer:

You should inquire about additional breast surgical imaging such as a breast MRI to more definitively determine what this mass is and how worrisome or not it appears to be. When trying to find a good surgeon, you should request to be referred to a breast surgical oncologist who is board certified and sees a large volume of breast patients. A Comprehensive National Cancer Institute Designated Cancer Center should have such individuals.

Question 4:

My daughter is 15 and noticed a small bb sized lump in her right breast about 7 months ago. I immediately had her seen by a breast cancer doctor. The doctor told us that at Meg's age, it is really unusual that she would have a lump like the one she has. The lump is very hard and is located right under her areola. The doctor did an ultrasound of the lump and measured it, it was, I think, 3 cm at that time. The doctor told me to bring Meg back In June or July to recheck it. If the lump had grown then it would need to be removed. Well, the lump has grown and is still very hard, it is like there are maybe 2 or three connected. The growth of the lump just occurred within the last month or so. Megan was afraid to tell me because she is afraid to go back to the doctor. She told my sister and then told me about this. We see the doctor this week on Thursday, we are both afraid and extremely worried.

Is this normal in a young teenage girl? The lump being very hard, does this have a specific classification? My mother was diagnosed with breast cancer 6 yrs. ago, and she is a survivor. Could this be a greater factor for my daughter? Also, Meg did say that she noticed the growth of the lump because it was tender and sore, is there meaning to this?  

Answer:

 It's not that unusual to see growths, usually found to be benign, in girls this age. Scary though it is, given it has grown it is time to look at investigating this more thoroughly. Before going under the knife, request that it be core biopsied in breast imaging so a diagnosis can be made before surgically removing it. 3CM is large so I'm hoping you mean 3MM instead. Make sure to see a breast surgical oncologist rather than a general surgeon, and someone with experience with young teens who also will recognize the importance of good cosmetic surgical closure afterward.

Question 5:

I am 22 years old, and I just had a baby. I have a lump in my breast. I had it checked when my son was born but the results were inconclusive. I was referred to a specialist by my doctor but they refuse to see me because of my insurance. I don't what to do now. 

Answer:

You should seek a doctor who is covered by your plan as you still need a diagnosis as to what this is. Do not let your insurance company be your barrier for getting answers. An ultrasound might be done to help evaluate this, especially if you are lactating since mammography and lactation don't go well together.

Question 6:

Hello, I have a lump in my breast that I am concerned about. I went to the University Health Services (I'm a graduate student) and they said it was nothing to worry about – but they didn't do any tests, just felt it, and it's a hard lump that has been there for four months now. If I go see another doctor I'm worried that my health insurance (through the university) won't cover it. What do I do? And what kind of tests would I ask for? I heard mammograms don't work in young women (I'm 28.)

Answer:

A mammography may provide the answer but it is generally recommended for young women to get an ultrasound as well since they have denser breasts making mammography a less effective diagnostic tool. Either way you need and deserve an answer so do not let your insurance hinder you. For starters, make an appointment with you GYN.