"I'm a logical person, but another part takes over," she said of how her mind had reacted on occasions when forced to wait for traditional mammogram films to be read. "When I go up to the hospital, I say, 'If you're out of the room for more than five minutes, tell me (the radiologist) is on a call or something. Don't leave me in that room for long.'"

Left alone, partially dressed and wearing a hospital cover-up, a person's mind is free to conjure horrific, though unfounded, reasons delays might occur.

"It happened once and my mind went crazy," Cline said. "When you're all worked up and sitting there in that little room by yourself and you're not dressed in case they need more images, even if you're the most logical person, your emotions can go crazy."

As a radiologist at South Peninsula Hospital, Dr. Jeffrey Quam has observed the reaction others like Cline have experienced and the difference digital mammograms make.

"Ninety-nine percent of the women coming in for exams are nervous. They've had a sister, mother, friend who has had breast cancer and they come in wondering if today's their day," said Quam, former director of the Breast Imaging and Intervention Center at Mayo Clinic in Scottsdale, Ariz. Digital mammography, however, is "less frightening, goes more smoothly and makes the whole exam feel better."

Another plus is that, while one unpleasant part of the exam breast compression is still required, the new unit makes it possible for mammography technologists to view images on screens in the exam room so the patient is not left alone.

The new, smoother operation means the exam is approximately 10 minutes shorter.

"We can actually take the image, review it right there in the room within seconds of taking it and make sure we like it and then go on to the next image," said Ruffholm.

Research has shown digital mammographies offer other benefits, especially for certain categories of women. A study involving UCLA showed digital mammograms to be 15-28 percent more effective than standard film mammograms when it came to detecting tumors in women younger than 50, women with dense breast tissue and women entering menopause. According to information provided by UCLA, those three groups are more likely to have fast-growing, aggressive tumors that need to be detected early to be cured.

Cline's experience, coming before digital mammography, underscores the importance of a fast response. She was in her early 30s when she discovered a lump on her breast during a self-breast exam. With her wedding only days away and guests due to arrive from all over the world, Cline didn't hesitate. She immediately sought medical attention, adding a doctor appointment to her lengthy, pre-nuptial to-do list. Four months later, after the first of three cycles of chemo, she discovered a second lump on the same breast. Calling her doctor, Cline was advised to wait to have it examined until her next trip to Anchorage for treatment.

"But you know, I only have one life to live and I'm not waiting," Cline said of her commitment to be her own best advocate and to aggressively pursue treatment.

Other benefits of digital mammography include electronic image archiving and tele-consulting. In cases like Cline's that involve treatment out of the area, that ease of sharing information could be crucial. With many Alaska communities off the road system such as Seldovia, Nanwalek and Port Graham Quam identified a two-sided importance. For starters, once patient confidentiality can be electronically guaranteed, he could send images to colleagues at Mayo Clinic for second opinions.

"And what's ideal for Alaska is that you can have mobile units that go out to remote areas, can take images and send them via satellite right here so patients don't have to get on airplanes because they don't have mammography equipment," Quam said, looking into the future. "Being able to access remote patients is a big part of the whole thing. The point is that it's now possible. That's marvelous."

Two computer screens in the exam room allow technologists to compare current images with an individual's past mammograms. For those concerned about radiation exposure, although traditional mammography is the lowest dose radiology exam, digital mammography uses even less, another point in its favor, according to Quam.

The new SPH digital mammography unit was funded by a grant from the Denali Commission and the hospital's capital funds. Patients coming to SPH for a mammogram must be referred by a physician to ensure adequate follow-up, according to Ruffholm. The cost of an annual mammogram is $326. In addition to Quam, Dr. William Robert also is an SPH radiologist, and five credentialed mammography technologists have been trained in the digital components.

Three years after being diagnosed, Cline gave birth to twins. In 2005, Cline and her husband purchased the Homestead Restaurant. Cancer-free, Cline continues to volunteer her time and share her experience with others facing the challenges of cancer.

From her firsthand experience, she said of SPH personnel, "It's a very caring bunch."

McKibben Jackinsky can be reached at mckibben.jackinsky.@homernews.com.