Joni Miller couldn't be sick. It was impossible.

Miller, 65, went to her doctor for an area on her skin that wouldn't heal in November 2015.

Her doctor, Dr. Jean Lu, scheduled Miller for a mammogram in February 2016. Miller said she had been neglectful of her own health, but her doctors' insistence that she get a mammogram may have saved her life.

While there is controversy in the medical world about how often women over the age of 40 should get mammograms, local radiologists the Times-Call contacted recommend annual mammograms starting at the age of 40.

After Miller's screening mammogram, the doctors noticed four masses in the breast tissue, including a deep one close to the sternum. Doctors told her to come back for a diagnostic mammogram. And that's when Miller started to panic a bit.

"Dr. Lu was adamant about me coming in to get the mammogram in February and then the letter came and it said come in and get a second mammogram so Dr. Lu made that appointment for me too," Miller said. "I immediately called my daughter who is a doctor and said 'Oh my goodness, what does this mean?' She said it was routine and I should go in."

Miller's sister died from an aggressive form of breast cancer at age 57 and she felt that lightning simply couldn't strike twice in the same family.

"I felt wonderful. I had no reason to feel that I was ill," Miller said. "I was sure that if one of mother's daughters had cancer, then nobody else would get it. I was just so confident that I didn't need to have this test as long as I was doing the self-exam."

Dr. Horacio Gutierrez, a fellowship-trained breast radiologist at Women's Imaging in Longmont United Hospital, said the idea of being called back is scary to a lot of women although it is fairly common.

"We expect between five and 10 percent of women to be called back for another mammogram. So if you have 1,000 women, let's say 80 of the women have to go back. Of those, most have nothing to worry about but about 12 of those go on to have a biopsy and then five of those have cancer," Gutierrez said. "But most turn out to have nothing at all."

No symptoms had been felt

Dr. Hilarie Gutierrez is also a fellowship-trained breast radiologist and works with her husband at Women's Imaging in Longmont United Hospital.

Hilarie Gutierrez said that Miller was reticent to come back for more tests and the doctors needed to be persistent with her.

"At that point, we didn't like the way it looked but we couldn't get her to come back in. Dr. Jean Lu was very good and her office called (Miller) and said that we really need to see Joni," Hilarie Gutierrez said. "In March she came back. Typically when we see something on a screening mammogram here, we see them the next day for more tests but it took a little longer to get Joni back in."

Miller also got an ultrasound and doctors told her they needed to biopsy the masses to see if they were cancerous.

Miller said she didn't feel any symptoms that she associated with breast cancer.

"They took me in for a second set of photos and then the ultrasound. I was sort of in shock. I felt t-boned ... I had no expectation of the diagnosis," Miller said. "It's important to understand that though the self-exam is important and good, the mammogram has to be that second set of eyes to look inside and see."

Hilarie Gutierrez said the doctors and staff at the center had to wrangle Miller in for the biopsy.

"Joni wasn't really interested. She said 'Nah, I don't need it. I'm fine.' She was almost kind of crawling off the table at that point and calling her daughter and saying 'I don't really need this' ... She was definitely not happy with me," Hilarie Gutierrez said, adding at one point she even took the phone in order to talk to Miller's daughter.

Miller said Hilarie Gutierrez tried to set Miller up with an early-morning appointment the next day for a biopsy.

"She said 'Can you come back in tomorrow at 7?' and then she looked at me and said, 'You're not coming back are you?'" Miller said. "I didn't respond and she looked at the staff and said 'Girls, can we stay?' And they all agreed and that in itself, the fact that they were willing to do it that day. Because if I had gone home and thought about it, I would have figured a way out of it."

Glad doctors persisted

Miller said that in her family, she is the caretaker — taking care of her older sister in the last six weeks of her life, her mother in the last five years of her life and her husband through an illness in 2015.

Miller said she thinks for many women,"our role has always been to be very confident in our own health and energy and the fact that we were sick or are sick just doesn't register."

Hilarie and Horacio Gutierrez both said they hear that all the time from women.

"We hear that they're too busy taking care of their husband or other family members to get sick,"Horacio Gutierrez said before turning to Miller and saying "We wouldn't have left you alone by the way if you didn't come back."

Miller said she was grateful her team of doctors, nurses and surgeons didn't give up on her.

"Finally when I realized that I could run but not hide, then we started the biopsy and I started calming down," Miller said. "I realized I had a plan ... I am so thankful that somebody as strong-minded as I am was in there saying 'No. You have to get this done.'"

Horacio Gutierrez added laughingly that he's used to strong-willed women running his household, as his wife smiled.

Miller had a double mastectomy to remove the masses. Now, she is encouraging the women she knows to go in for an annual mammogram after the age of 40 and in general, to take the time to go in for other regular check-ups.

"I suggest to people they choose a date they're going to remember like the day after their birthday or something and go and get the mammogram," Miller said. "We get so busy, we forget to make an appointment and people will say 'I don't have time for that.' No, you do have time because if you're not here anymore then what will happen to all the things we think are priorities?"

Miller suggested making the tests and regular health care a fun affair. She went out to dinner with friends after one of her tests. She had a spa day after one of the others.

"It's hard to contemplate how lucky I was, and I don't say that lightly," Miller said, choking up. "God had this."

Karen Antonacci: 303-684-5226, antonaccik@times-call.com or twitter.com/ktonacci

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