Next time you’re in a crowded restaurant, walking down a busy street or attending Sunday services, take a long look around and remember this: One in eight women will be diagnosed with breast cancer in her lifetime.
It is a statistic that leads to more than 260,000 new cases of invasive breast cancer and over 40,000 deaths each year, and Black women are especially vulnerable. However, Fernando Collado-Mesa, M.D., medical director of the Taylor Breast Health Center at Jackson Memorial Hospital, and associate professor of clinical radiology at University of Miami Miller School of Medicine, says you can take steps to reduce your risk and improve survival.
What are the numbers for breast cancer in general, and for Black women in particular?
Non-Hispanic white women and Black women have the highest incidence of breast cancer – about 125 newly diagnosed white women versus 123 newly diagnosed Black women per 100,000 women each year – but Black women have a 2-fold higher incidence of triple-negative breast cancer and are 19 percent more likely to die from the disease.
What does triple-negative mean?
Triple-negative breast cancer is an aggressive form of the disease that grows quickly and is more likely to metastasize and spread to other organs and parts of the body. It is also more difficult to treat and more likely to recur, so the mortality rates for women with this type of tumor is higher.
What about risk factors?
They can be divided into two groups: those you can modify and those you cannot.
Being overweight or obese, leading a sedentary lifestyle, drinking to excess and smoking – these are things that may increase your risk of developing breast cancer but can be changed for the better.
Things that cannot be changed include your age, genetic mutations, breast density, and reproductive, personal and family histories.
As women age their risk of breast cancer increases. Genetic mutations, such as those in the BRCA genes, significantly increase the risk of breast cancer, and these are more common in Black women and those of Bahamian descent.
Dense breast, which is a categorization based on what your breast tissue looks like in a mammogram, is a risk factor and makes it harder to spot cancer on a mammogram.
If you began menstruating before age 12 and went through menopause after age 55, you have been exposed to hormones for a longer period and that is a risk factor. Never bringing a pregnancy to term, giving birth for the first time after age 30, and not breastfeeding – all increase your risk.
Having a prior breast cancer diagnosis, especially before age 50, is a risk factor, as also is the use of some hormonal contraceptives and replacement hormonal therapy after menopause.
Family history, such as having a first-degree relative (mother, sister, and daughter) or several other relatives with breast cancer on either side of your family, also increase your risk.
There are far more risk factors that cannot be changed. Is that something women just have to resign themselves?
You may not be able to change those things, but if you are aware of them and act on that knowledge, you can improve your outcomes.
The latest guidelines from the American College of Radiology advise that all women, especially Black women and those of Ashkenazi Jewish descent, should be evaluated for breast cancer risk no later than at age 30, so that those at higher risk can be identified and can benefit from supplemental screening. That means knowing and discussing all potential risk factors with your general practitioner or OB/GYN so that you can learn and decide at what age mammography screening should begin for you, if additional tools like breast ultrasound or breast MRI are necessary, and what lifestyle changes you can make to help keep you healthy.
Early detection through appropriately timed screenings increase your chances of surviving breast cancer. For your breast imaging needs they are several excellent choices in our community, one of them is the Roberta Orlen Chaplin Digital Breast Imaging Center at Jackson Memorial Hospital. The center is staffed by experienced and caring personnel and has the latest 3-D mammography technology, high-resolution breast ultrasound, and breast MRI. When needed, the entire range of image-guided breast procedures, including biopsies, aspirations, and localizations are all performed at the center. All women with a final diagnosis of cancer are evaluated and managed according to the latest guidelines by a multi-specialty team of physician specialists from the University of Miami Miller School of Medicine.
So, the best advice is to be knowledgeable about risk factors for breast cancer, your particular life-time risk score, get appropriately timed screening, be proactive, and make sure you are taking care of yourself.
For more information on breast health visit www.jacksonhealth.org/jackson-memorial/radiology-breast-health-center/#gref. To schedule an appointment, call 305-585-6000.
Dr. Fernando Collado-Mesa, is a board-certified, fellowship-trained breast imaging radiologist.