Breast Cancer Awareness Month
October is Breast Cancer Awareness month, and it gives us all a chance to focus our attention and more importantly our action toward this life-threatening disease. Breast cancer has a devastating effect on the world and our country. Worldwide there are 2.5 million women diagnosed with breast cancer each year. In the U.S. there are around 322,000 people are diagnosed each year. This is a far-reaching disease.
Death rates rose slowly through the 1980s, peaked around 1989–1991, and then began to fall sharply driven by better screening and more effective treatments. Mortality rates have dropped 44% since 1989, preventing an estimated 517,900 deaths. The decline in deaths continues though the pace has slowed in recent years and this can be attributed to:
Earlier detection (mammography adoption beginning in the late 1980s).
More effective treatments (hormonal therapy, targeted therapy, immunotherapy).
Better management of metastatic disease.
Increased awareness and screening participation.
The reduction of deaths has been slowed due to the:
Rising incidence (up 1% per year since 2012).
Younger women (<50) seeing faster increases in incidence.
Screening disruptions during COVID‑19.
There you have it, the facts and figures of how pervasive this disease is. What we’ve done to improve detection and slowed the number of lives it claims each year, but the real story is about the people behind these statistics.
Last month I wrote about Alzheimer’s and how each of us most likely have had some sort of personal experience with this debilitating disease. I think the same thing can be said of breast cancer. In the past year I’ve had two close relatives affected by breast cancer. It instantly puts a face on these statistics. It really doesn’t matter to either one of my loved ones whether there were 322,000 people diagnosed this year with breast cancer or there was just one. They only know that they are now tasked with fighting this disease as best they can. Those around them can only focus on how they can help them through this ordeal. I’ve found that the often-used phrase, “call me if there is anything I can do” only serves to relieve the speaker of a portion of responsibility to the sufferer and often doesn’t lead to action. A better approach might be to talk with the caregiver closest to the patient, find out what the patient has told the caregiver would be most helpful, and see if you can do it. Don’t wait for a call, take action. I know it works.
There are other things we can do that will be a great service to our loved ones. I say it all the time - early detection is key. There are screening tests that can identify possible cancer before there are symptoms. These are things like mammograms, clinical breast exams, even self-breast awareness. These tests are one of the main reasons that the mortality rate has dropped 44% since the late 1980s. If you’re thinking that the rate is slowed and there isn’t any more improvement to be gained think about what happened during the COVID years. The number of screening tests dropped precipitously, and the number of late-stage diagnosis increased along with a rise in the death rate. That is recent, real-world proof that these screening tests work. All we need to do is take action.
We need to encourage our loved ones to take advantage of these cancer screening tests. There is an independent panel of national experts in prevention and evidence‑based medicine that reviews scientific research and issue recommendations on screenings, counseling, and preventive medications. It’s known as the U.S. Preventive Services Task Force. They recommend getting a mammogram every 2 years after 40 years old. The American Cancer Society has the following recommendation for mammograms:
40–44: optional annual
45–54: annual
55+: every 2 years or continue annually
Both of these are credible organizations, our job is not to worry very much on which recommendation is best, the important thing is to encourage the women in our lives to get tested. I’ve noticed some women are more focused on helping others and care giving than they are on their own health. Take action, be insistent, encourage as needed, offer to help schedule, and offer transportation. It could be a lifesaving service.
It is even more important if your loved one has:
BRCA1/BRCA2 mutation carriers
Strong family history
Prior chest radiation (e.g., lymphoma treatment)
Lifetime risk ≥20–25% (Tyrer‑Cuzick model – a series of questions to identify their risk level)
If your loved one falls into the high-risk category it might be advisable to have an annual MRI, plus annual mammogram. The important thing here is to get them to the doctor, schedule the screening tests, and follow medical advice.
Our healthcare system continues to discover new and efficient ways to detect and treat breast cancer, but its effectiveness is greatly reduced if we wait until the cancer is in its late stages before it’s found. It’s up to each of us to take action . . . be unrelenting in your quest to get the women in your life into the doctor to get these important screening tests done.
Best, Thair