Breast Cancer Awareness Month 2020 brought some big challenges to clinicians urging women to come back to screening facilities for mammograms, despite the COVID-19 pandemic.
This year, mammography facilities are back to normal volume, and that’s good news for the “vast majority of women who, if their cancer is diagnosed early, will be cured,” says Dr. Debbie Bennett, a Washington University radiologist and chief of breast imaging at the Mallinckrodt Institute of Radiology, part of the Washington University Medical Center.
Bennett, who oversees screening and diagnostic mammography at Siteman Cancer Center’s Joanne Knight Breast Health Center, says that for women whose cancer is found at an early stage, cure rates are “in the high 90th percentile range” and emphasizes that “it’s safe to come back now and have a screening mammogram. If you missed it last year, don’t delay any longer. It really is better late than never.”
The standard of care for breast cancer now involves some form of tailored treatment based on the tumor’s genetics. For instance, if tests reveal that a tumor is sensitive to hormones, targeted therapies can block specific chemical pathways needed for tumor growth.
“For the vast majority of women, breast cancer treatment is fairly straightforward, but for others, access to clinical trials can make a huge difference, and we have the ability to enroll our patients in those trials if it’s appropriate,” Bennett says.
“We’re also researching differences in screening recommendations for women from different ethnic groups,” she continues. “What a lot of research has shown is that Black women and Hispanic women tend to get breast cancers when they’re younger, and some of our screening recommendations currently might not capture those women before they feel a lump.”
Considering these findings, all women need to be screened for breast cancer starting at age 40, but some women may need screening earlier, depending on individual risk factors and race, Bennett says. Every woman should talk to her doctor by the time she turns 30 to identify risk factors that indicate whether earlier screening would be beneficial.
“We’re seeing that outcomes for breast cancer are worse for Black women in our community,” she adds.
While some of this may be due to biology, Bennett says, some is likely due to screening recommendations and socioeconomic factors that lead to health disparities. Access to high-quality mammography, transportation, child care, insurance status and health literacy are among the factors that create a disadvantage for lower socioeconomic groups.
“Some women don’t know where to go to get a mammogram or don’t know that, even if they don’t have insurance, a lot of screening mammograms are covered by state or grant funding,” Bennett says.
Bennett urges all women to help lower their risk through lifestyle measures, including maintain a healthy weight, moderate alcohol consumption, exercise and talk to a physician about the risks of hormone replacement therapy.
But most importantly, Bennett emphasizes, treat yourself to an annual mammogram and discuss whether additional screenings, such as breast MRI, are advised.
Center for Advanced Medicine Breast Health Center, 4921 Parkview Place, St. Louis, 314-454-7500, siteman.wustl.edu/prevention/mammography/joanne-knight-breast-health-center