Chapter Two: When the Question Became a Mission

"Sometimes the answer isn't finding a problem. It's realizing there's an opportunity to do something better."

After my mom’s diagnosis and my own genetic testing, I couldn’t move on.

I had too many questions.

As a mammographer, I understood breast imaging. I understood screening guidelines. But for the first time, I was looking at those guidelines through a completely different lens—not just as a healthcare professional, but as a daughter and as someone who had just learned I carried a TP53 pathogenic variant.

I started reading. Researching. Listening. Asking questions.

Trying to understand why my recommended screening pathway looked so different from what I had always considered “normal.”

Then I had a realization that stopped me in my tracks.

Growing up, I had often heard the advice that if your mother had breast cancer, you should begin screening ten years before the age she was diagnosed. My mom was diagnosed at 52. Ten years earlier would have been 42. For many women at average risk, screening mammography begins around age 40.

I remember sitting there thinking…

That wouldn’t have changed anything for me.

If I had relied only on that general advice, my screening recommendations wouldn’t have looked much different than someone at average risk.

But my genetic counseling appointment told a completely different story.

Because my personal and family history had been entered into a validated breast cancer risk model—and because my genetic testing identified a TP53 pathogenic variant—I learned I qualified for a very different screening pathway.

Annual breast MRI beginning at age 25. Annual mammography beginning at age 30.

That wasn’t a small difference. It was years earlier.

That was the moment everything clicked.

It wasn’t that one recommendation was wrong. It was that they answered different questions.

General recommendations are designed for broad populations. Risk assessment is personal.

It considers your history. Your family. Your risk.

That distinction changed everything for me.

I couldn’t stop thinking about the women I had cared for over the years. How many had faithfully shared their family history with their primary care provider? Their OB‑GYN? Their nurse practitioner? How many assumed that because they answered those questions, someone had already determined what that history meant for them?

The information often already exists. But unless someone connects those pieces through a validated lifetime breast cancer risk assessment, many women never learn what that history actually means for them.

That realization followed me everywhere. Into conversations with coworkers. Into quiet evenings with my family. Into the moments when I tried to move on but couldn’t.

I kept asking myself the same question:

What if every woman had the opportunity to understand her breast cancer risk before her first screening mammogram?

Not because every woman would be considered high risk. Most wouldn’t. But for the women who are… knowing sooner could completely change their screening pathway.

Eventually, I did what I’ve always done when I’m trying to solve a problem.

I grabbed a notebook.

I wasn’t writing a business plan. I wasn’t starting a nonprofit. I wasn’t trying to change healthcare.

I was simply trying to answer one question that refused to leave me:

What if there was a better way?

Page after page, I filled that notebook with ideas. Questions. Sketches. Workflows. Things that might work. Things that probably wouldn’t.

I had no idea those handwritten notes would eventually become Breast Imaging Matters.

But as the vision became clearer, I realized something important.

Identifying women at increased risk wasn’t enough.

If we were going to tell a woman she may be at increased risk for breast cancer, we also had a responsibility to help her understand what that meant and what options were available to her.

That’s when something shifted in my thinking.

I stopped thinking about awareness. I started thinking about access.

Awareness matters. Education matters. Advocacy matters.

But I didn’t want Breast Imaging Matters to become another organization that simply talked about the problem. I wanted us to help build the solution.

Because while women who have already been identified as high risk often have access to incredible healthcare teams—high‑risk clinics, genetic counselors, breast surgeons, medical oncologists—those programs only help the women who have already been identified.

My question became:

What about the women who haven’t?

What about the woman who doesn’t know she qualifies for annual breast MRI? What about the woman whose family history has never been entered into a validated breast cancer risk model? What about the woman living in a rural Oklahoma community where high‑risk clinics may be hours away? What about the busy mom in her thirties who is working, raising children, building a career, and taking care of everyone else?

If we wanted to reach her, we had to stop expecting her to come to us.

We needed to meet her where she already is.

At workplaces. At community events. At churches. At schools. At local businesses. On social media.

Wherever women are.

I don’t want women to have to go looking for Breast Imaging Matters. I want Breast Imaging Matters to find them.

Imagine seeing a simple QR code that says:

Know Your Breast Cancer Risk.

One scan. One validated risk assessment. One opportunity to better understand your health.

No complicated process. No wondering where to begin. Just one simple first step.

That became the vision.

Because women have a right to understand their own health. A right to know their breast cancer risk. A right to ask questions. A right to understand their options.

And when appropriate, they should have access to genetic counseling and the opportunity to pursue genetic testing—not because someone told them they had to, but because they deserve the information needed to make informed decisions about their own health.

Once that vision became clear, I knew Breast Imaging Matters couldn’t build it alone.

I began reaching out to organizations across the country. Not looking for sponsors—looking for partners.

Partners who believed access shouldn’t depend on where a woman lives. Partners who believed education should lead to action. Partners who believed women deserved a clear pathway—not just more information.

Those conversations eventually led me to Ambry Genetics and SequenceMD.

Ambry Genetics shared our commitment to evidence‑based hereditary cancer testing.

SequenceMD brought something equally important: access to licensed healthcare providers, experienced genetic counselors, and conversations that help women understand what their risk actually means.

Together, we began creating a model where Breast Imaging Matters could focus on what we do best—community education, validated breast cancer risk assessments, and navigation—while women who choose to move forward would have access to licensed healthcare providers, genetic counselors, and, when appropriate, genetic testing through our clinical partners.

Not another organization pointing out a problem. An organization helping build the solution.

We’ll begin that work here in Oklahoma. We’ll learn. We’ll improve. We’ll listen. We’ll build alongside the healthcare professionals already serving our communities.

And if we can create a model that makes breast cancer risk assessment, education, navigation, genetic counseling, and access easier for women here…

Then maybe one day it can help women everywhere.

Looking back now, I realize Breast Imaging Matters was never created simply to raise awareness.

It was created to build access.

Access to education. Access to validated breast cancer risk assessment. Access to genetic counseling. Access to healthcare professionals. Access to answers.

Because women shouldn’t have to wonder whether they’re at increased risk.

They deserve the opportunity to know.

Not someday. Not after their first mammogram. Not after a diagnosis.

As early as possible.

Breast Imaging Matters isn’t just building a nonprofit.

We’re building a pathway.

And this is only the beginning.

Chapter Three arrives next.

Ashley Flurry, RT(R)(M)
Founder, Breast Imaging Matters