Some situations in medicine are hard to erase from your memory. It is as if the encounter occurred yesterday. Those instances for me are generally those patients I have diagnosed with cancer or lost to cancer, particularly breast cancer. I can still see their faces and remember our conversations. These types of memories are difficult to release from your mind and heart.
Therefore, I honor them by doing my best to educate others about breast cancer. After skin cancer, breast cancer is the second most common cancer in women in the US. Each year, about 42,000 women and 500 men die of breast cancer. However, the death rate of black women is higher than that of white women.
Breast cancer symptoms can be different in individual patients and some patients may not have any symptoms at all.
Common symptoms include:
- A new lump or mass
- Bloody nipple discharge
- Breast pain
- Breast dimpling
- Change in size of the breast
- Thickening or swelling of the breast
It is important to see your provider immediately if you notice any of the aforementioned symptoms. Early detection and treatment of breast cancer improve outcomes.
Getting older and being a woman are two risk factors for breast cancer that you cannot change. Other non-modifiable risk factors include genetic mutations, having dense breasts, reproductive history, and family history. However, there are other modifiable risk factors that are worth discussing. For example, women who are less physically active, have increased risk of breast cancer. Normal weight women have less risk of breast cancer compared to women who are overweight or obese. Lastly, as alcohol intake increases, so does a woman’s risk of breast cancer. Women who have a family history of breast cancer or women who have inherited the BRCA-1 or BRCA-2 mutation, have increased risk of developing breast cancer.
Currently the best way to screen for breast cancer is with mammography, an x-ray of the breasts. Regular mammograms can lower the risk of breast cancer. Many organizations such as the American Academy of Family Physicians and American College of Obstetricians and Gynecologists support routine mammograms starting at 40, following discussion with the patient. If the mammogram is abnormal, additional testing such as a diagnostic mammogram and ultrasound may be needed. Breast MRI’s can also be used for women who are at high risk. Though some organizations now discourage self-breast exams due to the possible anxiety this may cause to patients, many providers still recommend women routinely check their breasts. I personally believe self-awareness is important in reducing risk of adverse outcomes of breast cancer.
I am not alone in my efforts to educate and support women as it relates to breast cancer. Many organizations in Saint Louis such as Valeda’s Hope, the Breakfast Club, Alpha Kappa Alpha Sorority, Incorporated, and The Links Incorporated (Archway, Gateway(IL), and the Saint Louis Chapters) have all been extremely active in the community providing support and resources. Their efforts paired with the vigilance of our individual villages, can help to reduce the disparities seen in Black women. Therefore, in honor of Breast Cancer Awareness Month, if you have not scheduled your mammogram, please do so and invite a friend!
Denise Hooks-Anderson, M.D., FAAFP is an associate Professor, SLUCare Family Medicine and interim assistant dean of Diversity Equity and Inclusion and St. Louis American Medical Accuracy Editor.