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The pink ribbon bonanza has arrived with October, the reliable sign that Breast Cancer Awareness Month is upon us.
The ribbon campaign is a good reminder for women to make an appointment for their annual mammogram (if they’re 40 or older) or to share as much information as possible with their doctor if they’re younger, officials said.
Texas numbers
The Texas Department of State Health Services found that 66 percent of women age 40 and older in the state have had a mammogram — an X-ray of the breast tissue — in the last two years. In its “2018 Female Breast Cancer Fact Sheet,” the department said there were 112 new cases of breast cancer in every 100,000 Texas women. And since 2015, 20 of 100,000 Texas women died from breast cancer. Mortality rates are higher for black women than their white and Hispanic counterparts, the fact sheet said. Since 2015, breast cancer has cost Texans $252 million in hospital bills.
A mammogram is a low-energy X-ray to show breast tissue. The screening technology is the most popular screening doctors use to detect breast cancer.
An ounce of prevention
The best way to prevent breast cancer is through screening, having a solid rapport with your doctor and lifestyle choices, said Dr. Carolyn Thomas, a Dallas surgical oncologist with Texas Breast Specialists.
“There has been a lot of information about guidelines out there, and it’s not all easy to understand,” Thomas said. “The best way to prevent breast cancer is through screening so that you can see something before you feel it.”
Not every woman’s risk of developing breast cancer is the same. Women tend to be either of average risk of developing invasive breast cancer in their lifetimes, or higher risk — which includes women who have a family or personal history of breast or ovarian cancer, are older and are positive for genetic mutations that are associated with breast cancer.
Many a breast cancer survival story begins with a trip to the doctor’s office after a woman finds a lump in her breast. Thomas said women shouldn’t wait, especially if they are 40 or older.
Breast magnetic resonance image, or MRI, is another screening method used to examine breast tissue for abnormalities. The bright white dot in the larger images is stage 1 breast cancer. The small images show the position within the body.
“With breast cancer, there are things that can’t be seen but can become palpable,” Thomas said. “A mammogram, an ultrasound or MRI can find things that can’t be felt.”
At 40, a woman with no family history of breast cancer should begin having a yearly mammogram and get routine annual physical examinations with their primary care doctor.
Women at a higher risk of breast cancer should consider visiting their doctor twice a year for exams, and can consider genetic testing to find out if they have genetic mutations associated with breast or ovarian cancer. Women who test positive for genetic mutations can get more comprehensive screening, Thomas said, adding ultrasound or MRI screening to twice-yearly mammograms.
“Some guidelines recommend that those with a higher risk — women who have family history or genetic mutations — start screening 10 years earlier than the age of their youngest relative’s diagnosis. So if the youngest relative was diagnosed at 45, you start getting screenings at 35. But it’s not black and white. If the youngest relative was diagnosed at 35, getting a mammogram probably won’t detect cancer because in your 20s, breast tissue is dense.”
And there are some invasive cancers that are difficult to detect with the typical screenings, too.
“If you’re at higher risk, when your primary care physician asks for your family history, you give as much information as possible about malignancies,” Thomas said.
Healthy choices
Thomas said diet and exercise are key preventative measures. Both play a part in managing a healthy, stable weight.
“It really, really is true especially for breast cancer,” she said. “Estrogen and progesterone are the two hormones associated with hormone-fed breast cancers. And with conditions like obesity — if you have a higher [body mass index], that fat tissue produces estrogen, which can increase your risk of hormone-fed breast cancers.”
The Breast Cancer Can Stick It! volunteers Casey Ramsey, left, and Paige Nalley pose for a picture at the Drummathon Klyde Warren Park in Dallas on Sunday.
Public health officials and researchers also advise that, in addition to healthy diet and exercise, women should manage stress and cultivate healthy relationships as a part of overall disease prevention.
And if a screening leads to a breast cancer diagnosis, Thomas said women shouldn’t put too much importance of cancer stages. Historically, oncologists put cancers in one of five stages — ranging from 0 to 4 — as a way of tracking the size of a tumor and if lymph nodes were affected. Doctors and patients used to consider a higher stage cancer to be more deadly.
Not so much anymore, Thomas said.
Jennifer Baker, left, helps her mother, Dawn Jonas, with survivor decals at Crossroads Fellowship Church on Sept. 15 in Odessa. Jonas is currently undergoing treatment for breast cancer. The two were at the Cups for a Cause 10K/5K run, sponsored by the Women’s Center of Odessa Regional Medical Center and Pink the Basin. The mission of Pink the Basin Inc. is to raise awareness of women’s health issues and to foster educational and services initiatives that positively embrace women’s health.
“Instead of hanging your hat on stages,” she said, “oncologists look at biological features to evaluate mortality and treatment. You can’t fit in on a chart on the back of the door in the doctor’s office. We’ve learned so much more about cancer biology, and both mortality and treatment has much more to do with the patient’s biological features.”
For more information about breast cancer and screening, visit http://bit.ly/2QoDJuk and for information on breast cancer risk, visit http://bit.ly/2Qq3MkL.
LUCINDA BREEDING can be reached at 940-566-6877 and via Twitter at @LBreedingDRC.
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