Kalispell family medicine doctor reflects on breast cancer diagnosis and treatment

Dr. Kelly Berkram remembers the moment she felt the lump in her breast. It caught her off guard — she had just had a normal mammogram, she was active and healthy and had no family history of breast cancer.  

Despite those factors being in her favor, the lump was indeed cancerous. It was hormone positive stage one, but aggressive, she said. The discovery began her own journey with surgery, chemotherapy and radiation, plus 10 years of hormone blocking medication to ensure the cancer does not return. 

Berkram was a vocal supporter of breast cancer screenings for her own patients, but after her experience, she knows first-hand how important it can be in catching it early.  

“It took me a while to get to the point where I just accept that, like, one in eight women are going to have breast cancer in their lifetime, and I am one of those,” Berkram said. “And it just happened, it wasn't my fault.”  

Breast cancer was nothing new to Berkram as a physician who had diagnosed many patients with it during her time in family medicine. Despite this, going through treatment herself gave her a new perspective and informed her of things she didn’t know about breast cancer.  

It was 2020 when she found the lump in her breast. She was 43 years old and working as a family medicine physician at Logan Health, so she asked one of her colleagues at the hospital to order her a mammogram. Her hospital connections got things moving a little quicker during the diagnosis phase. 

“It was 2020, right after everything kind of shut down. And so I went to my mammogram, and I knew the questions to ask — to figure out that the radiologist was sure it was cancer,” Berkram said. "I was the last patient of the day, and he knew me, so he said, ‘Do you want to just biopsy this right now?’” 

It took a couple days for the biopsy results to come back, and her colleague who ordered her mammogram had to break the bad news. But Berkram was already focused on what her next steps would be.  

HER PHYSICIANS began genetic testing on the tumor and determined surgery was a safe option. Once it was removed, she would need to undergo chemotherapy and radiation to ensure it does not return, since it was identified as aggressive.  

Chemotherapy was difficult for Berkram, who still lives with the neuropathy or nerve damage it caused in her feet.  

“I'm functional, but it has totally changed my life because I used to be a runner. I don't run anymore because it hurts, or I run very little,” Berkram said.  

It was hard to lose her hair too. Even though she didn’t consider herself a “girly girl” she felt shame around it and didn’t want people to see her. She leaned into wearing hats, some of which she got from Cancer Support Services at Logan Health and others that were curated by a good friend — both of which helped make the change a little easier to bear.  

She decided to start seeing a counselor during her treatment, too. She recommends this to her own patients now, because people have so many other things happening in their lives outside of a cancer diagnosis, it’s easy to feel overwhelmed. 

For Berkram, one of the greatest fears of all was how the cancer would impact her family’s future. 

“I felt confident that they would be able to treat the first go around, but I was fearful for if or when it could come back ... breast cancer is sneaky like that,” Berkram said. 

She was thankful to be able to take off work completely during the three to four months she did chemo treatments. But it was a grueling time — it was right at the start of the pandemic, so she had to wear a mask eight hours a day while she received infusions. These treatments made her feel very sick, and in between it all she was worried about being exposed to COVID-19.  

QUICKLY SHE realized she couldn’t do it on her own, but luckily her mother was able to join her. Her husband is a hospitalist at Logan Health and had to work while she had treatment.  

Neuropathy was a cause for concern from the get-go, she said. To deal with that and the other sickness she felt from chemo, she didn’t do anything “too out of the ordinary,” she said. But she did try icing her hands and feet on and off for 90 minutes during her infusions, which she believed helped prevent further damage.   

“Then my oncologist had me take some supplements to try to help decrease neuropathy also. So, I do think it would have been worse if I hadn't done those things, but I don't know,” Berkram said.  

There was a weight off her shoulders when she knew chemotherapy was over. She still had radiation, but she said it was a “walk in the park” compared to the other treatments. Though some people can get skin irritation and other side effects, Berkram found herself feeling better after months of dealing with chemotherapy.  

“I started radiation in October, and I finished in November, right before Thanksgiving and then I went back to work the very beginning of December,” she said.  

Berkram now runs her own practice in Kalispell called Apex Direct Care and thinks back to her experience with breast cancer when talking with her patients. She learned it’s important to “be your own advocate” in the health care system, so she’s more tuned in to anticipating what her patients may need from her.  

"I feel so much more empathy for what patients go through now, even if it's just not getting heard, or having a certain question or fear that’s not getting heard ... so now I think I’m better with my own patients and I think ‘What are they afraid of? What answers do they need for any kind of health stuff, not just cancer?’” 

In honor of Breast Cancer Awareness Month in October, Berkram said she encourages women to speak with their primary care physicians about setting up a breast cancer screening.  

The Flathead City-County Health Department offers the Montana Cancer Screening Program, which pays for breast and cervical cancer screenings for people who qualify based on age, income and insurance status. 

The program partners with local providers, which means it can be a regular appointment with the patient’s provider of choice. A form to enroll can be found at flathead.mt.gov/department-directory/health/population-health underneath the Breast and Cervical Cancer Screening Services tab. 

A similar program is also available at Logan Health through Save a Sister, which has provided more than 1,000 mammograms and ultrasounds for local women, as well as biopsies, lymphedema garments and nutrition classes, according to the hospital’s website. Logan Health also offers a mobile mammography unit with the goal of helping eliminate barriers for those in rural Montana to have a screening mammogram.  

More information can be found online at www.logan.org/services/womens-health/breast-health/

Reporter Taylor Inman can be reached at 406-758-4433 or by emailing tinman@dailyinterlake.com.