By Dr. Elayne Arterbery
Recently there have been incredible leaps in the ability to treat breast cancer. With greater understanding of the genetics of breast cancer, we have new tools for combating the disease and for giving women new options for improving their outcomes and survival. But for all the progress in treating breast cancer, some of the biggest challenges in improving outcomes for women lie at the starting point — effectively screening women for the earliest possible diagnosis.
In my practice as a radiation oncologist, I see this challenge every day, particularly among Black women. In general, too few women are getting screened when they should. Only about 67 percent of women who are eligible for mammograms actually have one. There are multiple reasons for skipping mammograms: fear, insurance issues, and lack of understanding to name a few. For women of color, missing or omitting mammography as part of health screening is a risky proposition.
Black women with breast cancer are more likely to die of their disease. Why? Missed screening opportunities mean some women will be diagnosed later, when the disease is more advanced and harder to treat and less likely to be cured. Black women are also at higher risk of being diagnosed with more aggressive types of breast cancer. And while half of all women have dense breasts, which can make it easier for cancers to hide on mammograms, it’s more common in Black women to have denser breasts.
So how do we close the gaps? For one, it’s critically important for every woman to know the importance of screening. While family risk due to genetic abnormalities have captured a great deal of attention, the vast majority of breast cancer is diagnosed in women without a hereditary risk.
Second, we need to look for ways to make cancer screening easier on women. One recent study makes a clear point about how important this is: It found that women who receive a false positive result are more likely to delay follow-up screening.
In truth, the imaging tools we use to spot cancer don’t always give us a clear answer. Too many women hear that their mammogram result was suspicious or abnormal, and end up in a difficult “grey zone” of decision-making. For these women, they will either undergo more imaging or biopsy, or ride out a worrisome six-month period of “watch and wait.”
That’s where the opportunity lies. The same kind of scientific leaps that have brought about new breast cancer treatment options are yielding new opportunities in detecting breast cancer. By understanding more about the unique biologic properties of breast cancer, one company has developed a new blood test that can help spot breast cancer’s unique protein signature and provide more clarity for physicians like me, when images give us fuzzy answers. An abnormal mammogram doesn’t always mean cancer and many women have additional imaging — the blood test in conjunction with the mammogram may indicate who actually needs additional imaging.
Click the Next button to continue reading …