Tuesday, October 31, 2023

"EARLIER DETECTION"- REACHING A GENERATION IN CRISIS




WHAT ABOUT IF YOU'RE TOO YOUNG FOR A MAMMOGRAM?   I went to my doctor for a lump I felt in my breast and she gave me a response that set off red flags: "don't worry about it". Being a researcher involved in breast density and breast cancer, I knew that I had to take action; I was fortunate enough to have my breast ultrasound training with Dr. Robert Bard (cancer imaging specialist, NYC) upcoming in the next week. Dr. Bard showed me how to use the ultrasound to help me find two benign tumors in my breasts, and it was there that he reported that I have dense breasts. Had I not taken action in getting screened at the young age of 22, I would have never known that I should be getting screened via ultrasound every 6 months (because having dense breasts puts me at a higher risk for breast cancer), nor would I have known that I had benign breast tumors. 

- ALEXANDRA FIEDERLEIN, 22
Cancer Researcher/ Graduate- Molloy Univ.

CURRENT DATA FROM PUBLIC SURVEY
Assembled by Dr. Roberta Kline, OBGYN & Co-Editor of Women's Health Digest

Source: CDC (link)


Enclosed is research-based public information by the CDC that widely supports the current reality about new cancers (including breast cancer) in women under 40.  The data used by public health comes from a wide variety of places within our local communities: hospitals, laboratories, doctors' offices – anywhere that a person receives healthcare.

Age-specific rates breast cancer for 2020 (Total for ages 20-39)
Rate of new breast cancers = 27/100,000
Equals 11,368 new cases/42,765,288 women

Details:
<20: numbers less than 16 cases for lower age categories, data suppressed
20-24: 1.7/100K; equals 174 new cases/10,239,813 women
25-29: 10.4/100K; equals 1,146 new cases/11,016,549 women
30-34: 30.5/100K; equals 3332 new cases/10,939,868 women
35-39: 63.5/100K; equals 6716 cases/10,569,058 women



"EARLIER DETECTION"...
REACHING MY GENERATION IN CRISIS
By: Alexandra Fiederlein (23)  | Edited by: Dr. Roberta Kline and the ICRS Editorial Team

I belong to the graduate-level age group that continues to witness the increasing numbers of breast cancer cases in our country.  The women in this generation also happens to be the next group that falls prey to being UNDERDIAGNOSED. Insurance companies and the medical community have made little or no action to support or identify the need for women in their 20's and 30's to be approved for  standardized early detection / breast cancer screening.  

From the front-row perspective, younger women are as much at risk of getting cancer. Reports show an uptick in genetic predisposition for breast cancer*, alongside a dangerous attitude of denial. Addressing this calls for widespread education and screening programs in our community as essentials to a life of wellness and prevention.  To subscribe to a regular screening routine at the early stage of womanhood raises awareness and prevention for decades to come.  Perhaps someday, installing breast cancer screening centers in  college campuses may be commonplace and a powerful step toward a national prevention initiative.

Click to download the latest ACS report
Targeting the young working PROFESSIONAL is a major part of our population, where the vast majority tends to put off checkups and screenings because they are just "too busy". Professional women need to value their health above anything else, and therefore the narrative needs to be amplified in that area. We find this problem to be quite prevalent in urban areas with the constant on-the-go culture. Offering local resources and improved access for personal scanning are just some progress driven programs. 

GEN Z is a sensible focus group because these are the women who absolutely must receive routine scanning. We need to advocate for the narrative that age 40 is not the starting age where screening needs to begin- especially since we are now seeing cancer cases in younger ages are growing in numbers. Getting OB/GYN professionals on board is especially important because this is where women are getting their prescriptions. 

We need to educate on the benefits of ultrasound. People need to know HOW it works, WHY it works, and why it holds certain benefits over a mammogram. People need to know that it is SAFE and EFFECTIVE, and this technology can save lives. I think it is especially important to emphasize the option of ultrasound for younger women. Many younger women have dense breasts and don't even know it, putting them at a greater risk (I wouldn't have known if it weren't for all of you!). Ultrasound is obviously a safe and effective screening method for young women. It is also not linked with the stigma/fear of getting a mammogram like many women my age hold (X-Ray exposure, etc.). 

If the drive for EARLIER DETECTION means proactive awareness, may this lead to turning social concern into clinical action.  This includes clinicians joining hands with advocacy groups who recognize the many potential areas for at-risk women in my generation whose lives and safety continue to go unrecognized. And once the count of cancer cases and deaths rise exponentially due to inaction, perhaps then will the medical community find urgency in upgrading the required breast cancer screening age to (finally) include generations like mine.  So say we all! 

Ref:
*Global Increase in Breast Cancer Incidence: Risk Factors and Preventive Measures, PMC9038417. (NIH)- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9038417/




A major concern is the presence of breast cancer in underserved communities, including those TOO YOUNG FOR A MAMMOGRAM.  Whereby the medical community touts the recommended (and legal/billable status) of getting a mammo scan should be between 40-50, what happens to the many women who do not fit this age criteria?  How would they even know to get checked without the support of their clinicians or an alarm from family history? Decades into the battle against breast cancer, clinicians and the public are much more educated about EARLY DETECTION, PREVENTION and the current protocols and modalities available to save lives.  Recent headlines on DENSE BREAST and the advancements in ULTRASOUND SCANNING supports a major part of this battle. SEE COMPLETE FEATURE


WATERBURY, Conn. (October 12, 2023) JOE CAPPELLO/ARE YOU DENSE? FOUNDATION RECEIVES KEY TO THE CITY FROM MAYOR O'LEARY
Waterbury celebrated a citywide Pink Out on Thursday, October 26th! Saint Mary’s Hospital Foundation has once again partnered with the City of Waterbury to recognize Breast Cancer Awareness. Waterbury Mayor Neil O’Leary, Saint Mary’s Hospital President, Kim Kalajainen and special guest Joe Cappello will address organizers and volunteers from the Waterbury Police and Fire Departments as well as the Education Department, area students and others at 11:00 a.m.  at Waterbury City Hall.  


Video News Release: Innovations in Early Detection

"Are You Dense?" Foundation Co-founder Joe Cappello joins the medical diagnostic community to promote the "Get Checked Now!" campaign. Dr. Robert Bard from the Bard Cancer Center (NYC) supports supplemental imaging including the 3D Doppler Ultrasound scanner to offer dense breast detection.  This video presents some of the latest advancements in ultrasound features to detect tumors through dense breast tissue- reportedly a significant challenge with mammograms. 




GO "EARLIER" WITH EARLY DETECTION (FOR WOMEN AGES 20-40)
According to the American Cancer Society (ACS),  women ages 45 to 54 and post-menopausal years are required to get mammograms every year.[1a] But for the underserved ages (20-40), the risk for breast cancer exists in growing numbers. In support of Breast Cancer Awareness month, the Integrative Cancer Resource Society, the AngioFoundation Institute (501c3) and the "Are You Dense?" Foundation  addresses the continuing concerns for breast cancer in the New York area by recommending early detection screening programs for women over 20 (and not just anyone 40+ as standardized by the insurance companies.

The medical community has identified over 5% of all breast cancer cases occur in women over 20 and under the age of 40. The increased risk for breast cancer in dense tissue also exists and is identified by the medical community.  Diagnostic Imaging specialist Dr. Robert Bard of NYC identifies the need for paying more attention to breast cancer screening to ages younger than the mandated 40+.  "It's about time the (medical) community recognizes the growing rate of breast cancer in women of younger ages... from genetic predisposition to geography to having dense breast tissue, earlier detection should be our next national initiative."

Breast cancer in younger women may be more aggressive and less likely to respond to treatment.

Women who are diagnosed with breast cancer at a younger age are more likely to have genetic mutations predisposing them to breast and other cancers.

Younger women who have breast cancer may ignore the warning signs—such as a breast lump or unusual discharge—because they believe they are too young to get breast cancer. This can lead to a delay in diagnosis and poorer outcomes.

Some healthcare providers may also dismiss breast lumps or other symptoms in young women or adopt a "wait and see" approach.

Breast cancer poses additional challenges for younger women as it can involve issues concerning sexuality, fertility, and pregnancy after breast cancer treatment. [1]


2) INCLUDE SUPPLEMENTAL SCREENING FOR DENSE BREAST TISSUE (WITH HIGH RESOLUTION ULTRASOUND): Women diagnosed with dense breasts should continue to get regular screening mammograms. But there are additional screening tests that can help doctors detect tumors that may not be identified by conventional mammography or DBT. [2]  Any woman who has dense breasts may want to consider supplemental screening, usually with breast ultrasound. Studies show that screening with ultrasound, in addition to mammography, improves detection of breast cancers in women with dense breasts. [3]

3) WHOLE BODY MRI (NO CONTRAST) FOR CANCER SCANNING: In simplistic terms, having a full-body access comports to the fact that everything is connected in one way or another.  Our full-body MRI provides early diagnosis and the largest view of the body, where finding any cancers in the body and/or where they may spread can provide the best chance of treatment success.  In suspected cases of early breast malignancy, the exclusion of metastatic disease is clinically vital and emotionally supportive.

1a) "Infographic: 7 Things to Know About Getting a Mammogram"- ACA/American Cancer Society: https://www.cancer.org/cancer/types/breast-cancer/mammogram-tips-infographic.html#:~:text=Women%20between%2040%20and%2044,choose%20to%20continue%20yearly%20mammograms.

1) "Breast Cancer in Young Women"- Cleveland Clinic: https://my.clevelandclinic.org/health/articles/16805-breast-cancer-in-young-women

2)  "What additional breast cancer screening tests are available for women who have dense breasts?"- Yale medicine- https://www.yalemedicine.org/conditions/dense-breasts#:~:text=Women%20diagnosed%20with%20dense%20breasts,(whole%2Dbreast%20ultrasound).

3) Columbia Doctors/ "What Are Dense Breasts? A radiologist offers guidance":-Health Insights: October 14, 2022 https://www.columbiadoctors.org/news/what-are-dense-breasts#:~:text=Any%20woman%20who%20has%20dense,in%20women%20with%20dense%20breasts.






"In order to catch cancer, you need to be able to detect it at an early stage so we can treat patients with the most effective mechanisms.  Ultrasounds are an easy, cost-effective method for screening for early breast cancers, especially in women below the age of 45, who are likely to have dense breasts. When you are young and premenopausal your breasts are dense and we know that breast density is linked to cancer and which also makes it harder for cancers to be seen on a mammogram. Although breast cancer is rare in women under the age of 40, early detection is key.  Public health campaigns are spending so much money on mammograms for this population of women who can easily and cost effectively be screened using an ultrasound."

"I LOVE this new program! Early detection is essential! There is a stigmatization around mammograms that they are painful and frightening. There is anxiety while you wait for the results. And, don't forget the appointment scheduling hassle.  Women, particularly younger women with active lives, small children, careers don't want to have to fit one more thing into their hectic and demanding schedules. However, mammogram technology itself has advanced and it no longer has to be a painful experience. Clinics and imaging centers are offering untraditional scheduling opportunities, such as very early morning appointments to late evening appointments that are timed for very minimal wait times. And, clinicians are often prioritizing mammogram interpretations so the results are back within 24 hours. The Self Care message is trending right now. Mammograms should be a part of self care."

27 Year Old Stage 3 Breast Cancer Victim Survived - Despite of Docs Who MISDIAGNOSED!

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