It was my first year of residency. I entered the room to see an elegant 50ish African American woman (very Mrs. Claire Huxtable like) waiting for me. She just moved to the state and was looking to establish care with a primary care physician. As we discussed her medical history (which was basically none), we then started talking about preventative care. She was in the age range for obtaining a mammogram which she was hesitant about. As I explained it further and discussed the risk of aggressive stages in the African American women, she informed me she has declined for the screening in the past and would like to think about it.
After each encounter with our patients as 1st and 2nd-year residents, we discuss our patients with the attendings. When I re-entered the room and asked for her decision, she was still on the fence. Again, I explained the screening process and the importance of it. She then agreed.
One month later, her mammogram results hit my inbox. The radiologist found a concerning location on one of her breast. I called her and asked that she come to the clinic. We hugged, we talked, and we discussed the next steps.
After the biopsy, she was found to have ductal carcinoma in situ. DSIC is a non-invasive or pre-invasive breast cancer which means the cells that line the ducts have changed to cancer cells but they have not spread through the walls of the ducts into the nearby breast tissue. She was told, “It was caught just in time.”
During her treatment, she came for a follow-up. She was thankful to me because it was caught in the early stages. I told her she made the ultimate decision to say “Yes” and decided to take control of her body and health.
October is Breast Cancer Awareness Month
1 in 8 women will develop invasive breast cancer over the course of her lifetime. As you can see SCREENING is IMPORTANT!
According to the United States Preventative Task Force, it is recommended for women to start screening from age 50 to 74. Other recommendations state to start mammograms every other year in your 40s. This is a discussion to have with your doctor and make the right decision for you.
Risk Factors
1. Dense breast: More glandular and fibrous tissue makes it difficult for a mammogram to detect
2. Family history of breast cancer: esp in a 1st-degree female relative (ex: sister, mother, daughter)
3. Race: Caucasian women are slightly more likely compared to other races however African American women are more likely to develop the more aggressive and advanced-stage breast cancer
4. Using Hormone Replacement therapy
5. Heavy drinking
6. Smoking
7. Overweight and obese women
8. Increases with older age: over age 55
9. Radiation to chest or face
10. Pregnancy history: Women with no children or have children later in life have a greater chance. (Breastfeeding decreases that risk)
11. Menstrual history: Start menstruation before 12 and/or menopause at an older age (after 55)
Prevention
As you can see from the above risk factors. There are some YOU have control of such as
1. Limiting your alcohol intake
2. Remain physically active
3. Breastfeed
4. Don’t smoke
5. Maintain a healthy weight
What is a mammogram?
A mammogram is a low dose of x-rays to detect breast cancer.
Why get a mammogram?
At times a patient with breast cancer does not have any symptoms. An abnormal lump or growth can be detected early with a mammogram. The earlier the diagnosis the better!
If you in the ages stated above, please discuss with her primary care physician and go get screened!
If you are not, spread the awareness of breast cancer screening. You may be helping to save a life today!
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