Debbie was a stay-at-home mom with girls aged 10 and 11 when she found a painful lump in her breast and went to see her doctor. She was sent to have a mammogram at the local hospital. "It's just an infection in a milk duct," her doctor told her. He prescribed an antibiotic and told her to take an over-the-counter painkiller.

Over the course of the next year, Debbie went back to the doctor several times because her breast still hurt and she could still feel the lump. The doctor simply continued to tell her to take painkillers and antibiotics. Worried about the pain and the lump, and not knowing where else to turn, she even went to the emergency room more than once. Her sister Donna reported, "In the ER, they told her, 'Debbie, you need to listen to your doctor. If he said it's not cancer, then it's not cancer. Cancer doesn't hurt.'"

After about a year, with Debbie still worried, another family member took her to a breast-care clinic run by the county health department. They ordered her to go that same day to a bigger city nearly 50 miles away to have another mammogram.

Donna said, "Within two hours, the doctor called her on a three-way call with the lab, apologizing. It was cancer." Donna took her sister to the first meeting with the surgeon. "Debbie said, 'I kept telling everyone about the pain and no one was listening,' and the doctor said, 'Debbie, 7 percent of women have pain with their breast cancer, and you're one of the 7 percent.' She put her arms around Debbie and held her. And Debbie started crying. It was the first time that someone had listened to her."

Within two weeks, she had a double mastectomy. The cancer was advanced and had spread to her lymph nodes. Debbie underwent radiation treatment and completed two full rounds of chemotherapy as well. Before long, though, the cancer had spread to her brain, her spine and her lungs.

On Debbie's birthday two years after she had been diagnosed, some family members had gotten a cake and started singing "Happy Birthday." Donna said, "I had to leave the room. How do you sing happy birthday to someone who is dying?" Debbie died the next day. She was 45. Her girls were 12 and 13.

Donna reflected on the experiences the family had with the healthcare system as Debbie was dying.

"Debbie had a mammogram at the hospital in the little town where she lived when she first complained about the lump and the pain. The films sat there for a year, and never made it into the doctor's hands. When my other sister Melody went to collect Debbie's medical records from that hospital a year later - after she was diagnosed - a technician handed her an envelope that said 'Cancer -- Urgent' on it. When Melody read that, she said, 'Why do you still have this? Why didn't her doctor have it?' The guy snatched it back from her.

"About 18 months after she was diagnosed, we took her to her doctor's office to get a copy of her medical records. He was no longer her doctor at that point. My brother went in with her. The nurse yelled at her. She said, 'Deborah, if you walk out that door with those papers, don't you ever come back here!' I was waiting in the car. When they told me what the nurse said, it took my brother holding me in the car to keep me from going back in there. You destroyed her life by telling her it was an infection for a year. Now you're yelling at her when she asks for her medical records?"

She continued, "I've seen that so often. The dentist for my twin sons said that they each needed to have two teeth pulled to make room in their mouths. When I said I wanted a second opinion, the dentist was furious with me. I think that's what people are afraid of - the doctor's going to be mad because you want a second opinion.

"I saw the same thing with my own daughter. She found a lump, and she was afraid to ask for her films. She was afraid that the doctor would be mad. I think that fear is the biggest problem people have."

When Debbie was told that she should accept whatever her doctor said, it put her in an impossible situation. In a small town with few doctors, she didn't have any obvious ways to get help when the ER told her to pay attention to her doctor, and her doctor dismissed her concerns.

Donna concluded, "After my sister died, I wrote a letter to the newspaper. In it, I encouraged women to take their health care into their own hands, and if their doctor tells them something they aren't real sure about, they should get a second opinion."

Even if they have to drive 50 miles to get it.