What you Should Learn From October Breast Cancer Awareness Month
Though Louisiana women are less likely to get breast cancer than other U.S. women, they are more likely to die from it, with the state having the second highest mortality rate in the nation. Why? One reason is that women in Louisiana often don’t have access to health care, resulting in a lack of screening, which often leads to the cancer being diagnosed in its later, more deadly stages.
There are two main ways to screen for breast cancer: mammograms and breast exams done by a clinician (which start for women in their 20s and 30s). Yearly mammograms for women 40 and over have been an accepted practice for a number of years. However, controversy erupted recently when two Danish scientists, who had reviewed the evidence on mammograms and, after eliminating studies they thought flawed, concluded they did not lower a woman’s chance of dying from cancer - though one of those scientists has since said the evidence as a whole shows mammography likely reduces the risk. Adding to the confusion, the U.S. Preventive Services Task Force (USPSTF), in a different analysis, concluded that regular mammography in women ages 40 to 49 saves lives, but that the effect is more modest than for older women. Given that small difference, the USPSTF is studying the issue further before making its breast cancer screening recommendations.
What Women Should Do
What is clear is this: One in eight women will develop breast cancer during her life and one in 36 will die from it. Breast cancer is the most common form of cancer in women, aside from skin, in the United States and it is the second leading cause of cancer death in women, after lung. (It should be noted that both skin and lung cancers are highly preventable).
What is also clear is that major health organizations all agree that women 50 to 74 years should have regular mammograms, with no more than two years between them and most recommending yearly screenings. On the more controversial point as to whether or not women should start screening at age 40, organizations such as the American Cancer Society, the National Comprehensive Cancer Network and Susan G. Komen unequivocally recommend women starting at age 40, while others such as the Centers for Disease Control and Prevention and the American Medical Association recommend women 40 to 49 discuss the issue with their doctor, so they can weigh risk factors, benefits, etc. and make an informed decision for themselves. As the National Cancer Institute noted “women aged 40 to 74 years who have screening mammograms have a lower chance of dying from breast cancer than women who do not.” So although there is no blanket age-40-and-up breast cancer screening recommendation, health organizations agree that it is a serious issue that women need to consider when they reach 40.
Breast Cancer Symptoms
There is also no question that if you are experiencing symptoms you should see a doctor right away. Symptoms include:
- New lump in the breast or underarm (armpit)
- Thickening or swelling of part of the breast
- Skin irritation or dimpling
- Redness or flaky skin in the nipple area or breast
- Pulling in of the nipple area or the breast
- Nipple discharge other than breast milk, including blood
- Any change in the size or shape of the breast
- Pain in any area of the breast
Breast Cancer Risk Factors
People who have factors that increase their risk for breast cancer need to be vigilant about screening. As noted, being female and older are two of the biggest risk factors (women are 100 times more likely to get breast cancer than men), while other risk factors that people cannot change include:
- Genetics (including BRCA1 and BRCA2); Angelina Jolie had this gene mutation, which meant a 65 percent risk of getting the disease and was why she elected to have a preventive double mastectomy
- Personal and/or family history of breast cancer (first-degree relatives on mother’s or father’s side, i.e. mother, sister, daughter)
- Dense breasts (more glandular and fibrous tissue, less fatty tissue); be aware that dense breasts can make mammograms less accurate
- History of lobular carcinoma in situ
- Menstrual periods; women who started menstruating early (before age 12) or went through menopause late (after 55)
- Previous chest radiation
- Exposure to diethylstilbestrol (DES)
- Long-term use of hormone replacement therapy
Lifestyle-Related Risk Factors
- Women who have had no children or a first child after age 30
- Drinking alcohol
- Being overweight
- Lack of physical activity
More recent studies are also linking tobacco smoke and night shift work to breast cancer.
LBCHP Offers No-Cost Mammograms
The Affordable Care Act requires all health insurance companies to cover mammograms. In Louisiana, women in what is often called the “working poor” group (generally people for whom health insurance equals between a quarter to half of their income, but who are not eligible for Medicaid) may feel they have no options for getting mammograms. Those are the people the CDC-funded Louisiana Breast and Cervical Health Program (LBCHP) is designed to help. LBCHP performs no-cost breast and cervical cancer screenings (including mammograms and Pap tests) for low-income, uninsured and underinsured women across the state and, thanks to a recent expansion of funds, will set a goal to reach approximately 14 percent of Louisiana’s eligible women this year. Following is the list, by area, of LBCHP Mammography Providers:
New Orleans Area:
- Interim LSU Hospital
- St. Thomas Community Health Center
- NOELA Community Health Center.
Baton Rouge Area:
- Woman’s Hospital
- Mobile mammography services also available
- Leonard J. Chabert Medical Center
- University Hospital & Clinics
- Louisiana Oncology Associates
Southwest Louisiana & Central Louisiana Areas:
- LBCHP is looking for providers in the Lake Charles and Alexandria areas now. To find the current closest screening locations, go to www.lbchp.org or call 1-888-599-1073.
Northwest Louisiana/Shreveport Area:
- Partners in Wellness Feist-Weiller Cancer Center
- Mobile mammography services also available
Northeast Louisiana/Monroe Area:
- University Health Conway
Florida Parishes/Hammond Area:
- Lallie Kemp Medical Center
For more information on LBCHP, eligibility, screening locations and more, please go to www.lbchp.org or call 1-888-599-1073. If you wish to help Louisiana women diagnosed with breast cancer overcome one of their biggest obstacles to care: transportation, please make a tax-deductible gift to LBCHP at https://thebreastcancersite.greatergood.com/store/bcs/item/62768/?origin=ORIGIN.
The Louisiana Comprehensive Cancer Control Program (LCCCP) is working to raise awareness about six priority cancers that can be prevented or mitigated by screening and lifestyle choices, including breast. The Louisiana Breast and Cervical Health Program (LBCHP) is one LCCCP’s fellow programs under the umbrella of the Louisiana Cancer Prevention and Control Programs (LCP) housed at the LSU Health Sciences Center School of Public Health. For more information, go to www.louisianacancer.org.