Lightning struck Karol Scott's family three times.
She was diagnosed with breast cancer at age 44. A mammogram caught the Stage 1 sickness, but after surgery, four rounds of chemotherapy and 30 days of radiation, she's been cancer-free for two decades.
Her twin, Karon McCormick, younger by eight minutes, was diagnosed with Stage 1 breast cancer after a routine mammogram in November. Karon had intraoperative radiation therapy - a one-time dose of radiation directly to the cancer site - while she was under anesthesia during her lumpectomy. Doctors will monitor her closely for the next decade.
Younger sister Julie Edmunds was diagnosed with Stage 1 breast cancer in June after several rounds of suspicious mammograms, and she had a double mastectomy in July. Though she plans to have reconstructive surgery and permanent implants put in this year, she doesn't miss what once was.
"I found out when I had my mastectomy what a handicap they were," said Edmunds, 56. "I told my doctor, 'I feel really bad, but is it terrible for me to say I don't miss them at all?' No more wagon-wheel ruts in my shoulders."
Ultimately, the three sisters - all treated at UCHealth Memorial Hospital - are fierce about their message: Get a yearly mammogram.
"You have to stay in front of cancer," said McCormick, 64. "You don't want to play catch-up with it."
Since her diagnosis, McCormick has been an education volunteer for Susan G. Komen, a nonprofit organization that addresses breast cancer in multiple ways, including research, community health and public policy. She travels around the state educating women on mammograms.
"I run into women all the time who are fearful of finding out what they don't know," she said. "They refuse to get a mammogram. We want to promote the early detection method. We don't want to see anybody else dying."
The recommended start date is 40, though women are highly encouraged to get them earlier once a family member is diagnosed.
"It's really important," said Nancetta Westcott, executive director of the local Susan G. Komen chapter. "Komen still recommends you consider an annual mammogram and recommends you speak to your doctor. There are some women at low risk that can probably go a little longer, but if it's me, I want to know. The majority of doctors and Komen still recommend every year."
The two biggest risk factors for breast cancer? Being a woman and getting older.
The numbers only reinforce the sisters' message: 1-in-7 women in Colorado will be diagnosed with breast cancer, compared with 1-in-8 in the country. Research hasn't settled on why chances are higher here, but it correlates to studies that report Colorado women for unknown reasons also have a higher risk of stroke and multiple sclerosis.
Another startling number: About 85 percent of those diagnosed will have no family history of the disease. Twenty years ago, a family history of breast cancer seemed like the biggest predictor of the disease, which might have done some women a disservice. Only 10 percent to 12 percent of breast cancer cases are genetically connected.
"Sometimes the breast cancer that is genetically connected may be a bit more aggressive," Westcott said. "It may be harder to treat. If I have a family history, I'm going to check it out more closely. But just because you have no history doesn't mean you shouldn't be getting mammograms and living healthy and not adding weight."
Another possible disservice to inspiring early detection was celebrity Angelina Jolie's announcement in 2013 that she had a preventive, bilateral mastectomy after learning about a mutation in her BRCA1 gene, which can increase a woman's chances of developing breast and ovarian cancer.
"When somebody like Angelina has the BRCA1 gene, everybody gets concerned," said Westcott. "They think, 'I don't have any, so I'm not going to worry about getting a mammogram.'"
McCormick and Edmunds were tested for BRCA1 and 2 and came up negative. The test wasn't available 20 years ago, when Scott was diagnosed.
"That tells me you can't rely on that either," Edmunds said.
"I was talking to a nurse," McCormick said, "and she said, 'You've got a gene in there somewhere, but they just haven't identified it yet. They'll find it.'"
Once a family member is diagnosed with breast cancer, all female relatives should begin scheduling mammograms. Because of her sister's diagnosis 20 years ago, Edmunds started at 35.
"I was faithful," she said. "I had been having them for 20 years. I had a clean 20 years, and it was No. 21 that took me down."
Early stages of breast cancer can be undetectable in a self-exam, which also might deter women from getting mammograms. None of the sisters felt anything unusual before their diagnoses.
"A lot of women think you can feel it," said Scott, "and you can't."
"At some point, you're going to find out," said McCormick, "and how silly are these women going to feel when they're lying on their deathbed saying goodbye to loved ones when they could have done it early and been here like Karol 20 years later? It's a 15- to 20-minute appointment."
Women without health insurance might be tempted to skip the annual exam, but help is available. Westcott hears from people every day who don't have the financial means. She tries to connect them with as many alternatives as possible, including Peak Vista Community Health Centers and Dream Centers, which try to help women qualify for Medicaid. If they don't, they're referred to the Colorado chapter of Women's Wellness Connection, a national early cervical and breast detection program.
"If a woman calls any breast health center in the Springs, they will get either a 'Make an appointment and come in and we'll figure out finances later' or recommendations as to where they might go."