SAVING BREASTS, SAVING LIVES

TAKE THE FIRST STEP

BY PATRICIA MARAN, MD, FACOG LEHIGH VALLEY HOSPITAL AND HEALTH NETWORK

As this October comes, I am reminded of Breast Cancer Awareness Month and the amazing grass roots organization that the Susan Komen Foundation has become. We will see pink ribbons on yogurt cap and soda bottles, pink shirts and socks on ballfields and soccer pitches.

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We will watch people pay tribute to their mothers, sisters, daughters, and aunts during local road races and fundraisers.

But what might not be seen behind all the publicity is the sheer volume of families affected by breast cancer. It’s not just the women of our community affected. It’s the men who will be diagnosed; the fathers left widowed raising children; the husbands who spend long hours sitting in waiting rooms hoping their wives emerge from the radiation suites and chemotherapy infusion centers. The quiet down time when all the ribbons, balloons, and fundraising starts to dissipate are the very parts of the day that feel inevitably altered once this diagnosis arrives on one’s doorstep.

As an obstetrician/gynecologist, every day, multiple times a day, I am literally examining, talking about and touching breasts. Breastfeeding, formula shortages, sore breasts from hormone changes, saggy breasts with yeast infections underneath, tight back muscles from pendulous breasts. But the conversation and exam that both patients and doctors alike fear, are chief complaints such as “I found a lump” conversations, or “the mammogram needs to be repeated” conversations.The unspoken fear lingering in the exam room is a palpable belief that if one is diagnosed with breast cancer, one will die. I would propose though that the fear of breast cancer comes from an outdated perspective that every lump or bump is cancer, and every breast cancer may require poking, prodding, cutting, chemotherapy, radiation and that breast cancer generally kills people. And the sad reality is that this fear very often prevents people from doing the one vital step that very well may lessen the gravity of the diagnosis, and that is to get a mammogram.

The reasons are many, but over the years, the most common excuses I hear are comments such as: “I don’t have insurance, I can’t get a mammogram.” There are multiple ways we can subsidize those community members needing preventative screening who may not have insurance.

“What’s gonna change if they find it on mammogram, I’d just get a mastectomy anyway?” While some women medically will require a mastectomy depending on the type and size of the breast cancer, the majority of breast cancers can be treated with

a lumpectomy. Scientifically, we also know that having a mastectomy does not necessarily change the need for chemotherapy, nor does it improve survival rates. With new targeted hormone therapies and chemotherapy, the options for treatment are multi-faceted.

“I DON’T HAVE TIME.”

LOOK AT YOUR CHILDREN AND GRANDCHILDREN. MAKE TIME.

“You have to die somehow, right?” Statistically the majority of people will die of a cardiovascular event or complication from cardiovascular disease. That being said, metastatic cancer–of any kind–is not the easiest or least painful way to die.

“All that radiation for the mammogram, doesn’t that cause cancer, not find it?” The quality of the mammography machines we use now are far more efficient and less apt to lead to radiation exposure. On the other hand, if you do have breast cancer, rest assured radiation treatment is far more caustic than screening xrays.

“It hurts.” Truly if you are afraid of the pain, or are too anxious to go for the mammogram, please ask your doctors for either an anxiolytic or take some pre-procedure over the counter motrin or tylenol. Also, if you are still menstruating, consider scheduling the mammogram after you have completed your menses; it does seem less painful with these simple interventions.

The basis behind all of these statements is palpable fear. Fear of the unknown often prevents people from seeking the care they need. So let me clear up some of the unknown with current statistics. If women are ages 40 and above, or have any new onset symptoms such as lumps, breast discharge, or visible changes, these folks need to seek care. These days more and more patients are becoming survivors of breast cancer rather than victims to it.

The majority of these people internationally do not have access to the screening and treatment regimes we have in the United States. Statistically more and more patients are becoming survivors. This 42 % decline has come from marked improvements in both the way in which we treat patients, but also the understanding that breast cancer is a very broad term for the multiple types of breast lesions that may occur and the individualized way in which we can now treat them.

In the U.S, breast cancer mortality is about 40 percent higher in Black women.

This statistic is unacceptable. While scientists do not know exactly why Black women are more apt to die from breast cancer, let’s be really clear. Race matters. If the Covid pandemic has taught us nothing, it certainly has shed light on the sad reality that equity and access to medical care in our communities is not equal.

This autumn when a pink ribbon comes into view, ask the people in your life: have you gotten a mammogram this year? If the answer is no, please reach out, find a friend, make a date, call for the appointment. Maybe even plan a lunch or shopping outing. Breast cancer research and treatment is a story of hope, of advocacy, of prevention, and of medical advancements. For this, we may all offer a huge sigh of relief.

The statistics included in this article have been taken from the Susan Komen Foundation website at https://www.komen.org and verified with article citations.

STATISTICS : Every 46 seconds, somewhere in the world, someone dies from breast cancer. That’s more than 1,876 women and men every day.

Improvements in early detection and treatment contributed to a 42 percent decline in the breast cancer death rate in the U.S. between 1989-2019.

For the most up to date screening guidelines, consider checking out the website: www.nccn.org.

To consider joining this fall’s local fundraiser, sign up for our local annual walk/run in the Lehigh Valley Parkway.

https://womens5kclassic.org/