Since 1985, October has been a month that is festooned with Pink Ribbons—the ribbon color that signifies breast cancer awareness. Those awareness efforts have really paid off. Overall breast cancer rates have been steadily decreasing since the year 2000, and the death rate for breast cancer has been decreasing since 1989. Those pink ribbons have made a difference. People are more aware of their breast cancer risk, and are getting screens which detect cancers earlier—which makes it much more likely they will be cured of the cancer rather than dying of it.
But, that good news doesn’t mean we can stop talking about breast cancer. Breast cancer is second only to skin cancer in cancer diagnoses for women. The only cancer that kills more women is lung cancer. Statistically, 1 in 8 women will develop breast cancer in their lifetime, an estimated 269,600 cases will be diagnosed in 2019. While it is much rarer, men can get breast cancer too. The chances for men developing breast cancer is 1 in 883. While we are getting better at treating and preventing breast cancer, there is still much work to be done. 34 years after Breast Cancer Awareness started, those pink ribbons still matter.
The best method for finding breast cancer early is by a screening test called a mammogram. Finding breast cancer early is so important because that is also when it is easiest to treat. A mammogram is a specialized x-ray specifically designed to look for changes in breast tissue. Mammograms can detect changes smaller than can be felt in the breast by a physical examination. The US Department of Health and Human Services recommends that women aged 40-49 talk to their primary health care provider about when they should start getting mammograms, and that women aged 50-74 get a mammogram every two years.
As a health care provider, one of the things that really bothers me about early detection of cancer in general is a phenomenon called “cancer disparities”. The National Cancer Institute describes a cancer disparity is when outcomes for cancer treatment are different between different population groups. Cancer disparities can be related to things such as disabilities, gender/sexual identity, geographic location, income, and education. For example, the poor and medically underserved (rural communities) are less likely to have recommended cancer screening tests—which then means when cancers are diagnosed, they are generally late-stage and difficult if not impossible to treat. One of the great things about mammograms is there are many programs that offer “scholarships” for people who do not have insurance or cannot afford a mammogram. For instance, here in the Permian Basin, Pink the Basin has raised over $2 million for mammogram screening and breast cancer support for our underserved population. Please contact any of the breast care centers here in Odessa for more information on mammogram “scholarships”. In addition, in Texas, you do not need a prescription for a screening mammogram, but the specialists doing the mammogram do need to send the results to a doctor who can help you interpret those results. The non-prescription version is also for a screen. If you have cancer risks, a diagnostic mammogram (a more detailed type of mammogram) may be a better option. Only your health care provider can help you make that decision, so please speak to them about your best option.
Another thing that can cause cancer disparities is biology and genetics. For instance, African-American women are more likely to get the triple-negative type of breast cancer, which tends to me a more aggressive breast cancer with a higher death rate. 5-10% of breast cancers are linked to mutations of the BRCA1 and BRCA2 genes. Women who have the BRCA1 mutation have a 72% risk of breast cancer in their lifetime. 15% of women diagnosed with breast cancer have a family history of breast cancer. Please remember though, does not eliminate the risk for folks who do not have that biologic/genetic disparity. 85% of breast cancer occurs in people without a family history. Those disparities again emphasize how important it is to get a mammogram and speak to your health care provider about mammograms. Mammograms and early detection can quite literally save a life. Please speak to the women in your life about getting a mammogram.