Nancy Carlson is in charge of a huge hospital.
"I'm so busy with what I do day in and day out," said Carlson.
This chief executive of Providence Little Company of Mary Medical Center in San Pedro is also a registered nurse. As a healthcare leader, she advocates prevention. But even with a mammography clinic just steps away, Carlson went nearly a decade without an appointment.
"I'm running a hospital, I've got a family, I'm 'too busy' to take care of myself," said Carlson.
During this time, Carlson was caring for a daughter with end stage cystic fibrosis. In 2008, she came across what she believed to be a tumor.
"It was invasive ductal carcinoma. In fact, I had two tumors," said Carlson.
Dr. Moshe Faynsod, chief of surgery, said it could've been picked up much smaller if mammography had been done routinely. Carlson was devastated and felt like a hypocrite.
"I'm using myself as a very bad role model," said Carlson.
She felt that moral obligation so deeply that she decided to write a personal note to every woman with a mammogram appointment.
"I am among the many women who did not keep scheduled mammogram exams. In my case, for nine years because I was too busy," Carlson says in the letter. "Don't repeat my mistake. Please keep your scheduled appointment for your mammogram."
Making an appointment for a mammogram is not enough. The no show rate at this hospital is about 50 percent. That means half of the women who make an appointment don't show up.
"You have to show up and you have to do the screening in order for us to be able to help you," said Dr. Sam Zeim, director of mammography.
Carlson's tumors were slow growing. She responded well to a lumpectomy and radiation. Now, she's been five years without cancer.
"I just feel very fortunate. I lucked out. It certainly wasn't because I was being smart about my health," she said.
She's a reminder to women about what could happen when you say you're too busy to get a mammogram.
"It's minimally uncomfortable. It takes a few moments out of your day once a year. It's the right thing to do for yourself and your loved ones. There's just no excuse," said Carlson.
While there are differing guidelines on when and how often a woman should get annual mammograms, most experts agree a woman should discuss their screening strategy with their doctors. October is Women's Health Awareness Month.