Shift successful breast cancer awareness efforts to prevention
Not very long ago the words “breast cancer” were not even spoken in public. But over the past 30 years awareness of breast cancer has improved dramatically and there are now fundraising events held and races run to promote breast cancer awareness and to support research and treatment of this disease.
There is even a color for breast cancer. Who would have ever thought that NFL receivers would proudly be wearing pink gloves in games?
Now the words “breast cancer” and the symbols that remind us of the disease are ubiquitous in our society, and not just during October, which is National Breast Cancer Awareness Month.
Breast cancer is a common disease, affecting approximately one in eight American women. The current cure rate for breast cancer is now up to approximately 80 percent, but once breast cancer has spread beyond the nearby lymph nodes, the cure rate is depressingly low. Women (and men) who have had their cancer spread have many more options that prolong life than even a decade ago, but the disease inevitably returns and ultimately is fatal.
Now that we have done a good job of raising awareness of the disease, how do we translate that awareness into fewer deaths and less disability from breast cancer? Despite some mild controversy about at what age initial mammograms should be instituted, it is generally accepted that mammographic screenings save lives.
The American public has been well-educated as to the need for mammograms, but an alarming percentage of women do not comply with these recommendations. Breast cancer awareness has succeeded with regard to mammography, but compliance has not kept pace.
There are numerous explanations for the low compliance rate. Mammograms are uncomfortable. Mammograms are too expensive for many people without adequate insurance coverage. It can be inconvenient for some people to make time for mammograms. However, while mammograms have not become less uncomfortable, breast cancer screenings are now done at more locations and even evening screenings at times can answer the excuse of inconvenience. New provisions of the soon-to-be-instituted Affordable Care Act will remove some of the financial barriers to this life-saving screening.
Awareness of the need for screening has increased dramatically; However, the awareness of actual prevention of this disease has lagged.
We now have several drugs that have been shown to reduce the development of breast cancer in high-risk women by anywhere from 50 to 65 percent. This reduction in cancer development is as simple a taking one pill per day. If the cancer never develops, there is no need for surgery or chemotherapy or radiation and most importantly, there are no deaths.
Women are not aware of this option and, unfortunately, many primary care physicians are also not yet aware of these options. So our task of raising awareness this October must take this further step.
If you or someone in your family has had breast cancer, then other family members may be at increased risk. If anyone in the family has had ovarian cancer, then the risk of breast cancer may be increased. If you have had non-malignant abnormalities on a previous breast biopsy, then your risk might be increased. These risks increase with age so these considerations are particularly relevant, but not limited to, women who have passed menopause.
So this year we need to raise awareness of this aspect of breast cancer. Ask your physician to address whether you should be considered for prevention. Let’s not just focus on finding and treating breast cancer, but let’s try to prevent people from ever getting breast cancer in the first place.
As the old saying goes, “an ounce of prevention ...”
David Ellison, M.D., of Charleston Hematology Oncology Associates, is the medical director of Roper St. Francis Cancer Care.