Daily Local News (West Chester, PA)
GET SCREENED
Mammograms are still critical during the pandemic
An estimated 12,180 women in Pennsylvania will be diagnosed with breast cancer this year. According to the American Cancer Society, one in eight women will be diagnosed with invasive breast cancer in their lifetime, and one in 39 will die from breast cancer. In Pennsylvania, one in seven women will be diagnosed with breast cancer.
This month, for Breast Cancer Awareness Month, Tower Health is emphasizing the importance of women scheduling their annual mammogram. Last year, Tower Health hospitals diagnosed 696 patients with breast cancer.
“The importance of getting your annual mammogram is early detection of an abnormality,” said Dr. Michael Brown, oncology service line director at Tower Health and medical director at McGlinn Cancer Institute at Reading Hospital. “Early detection often equates to a much higher cure rate. Whenwe find the cancer on mammogram, most often it’s very small and usually at a very curable stage.”
Impact of COVID- 19
Tower Health has seen a 6% decrease in screening and diagnostic mammograms between last fiscal year and this fiscal year. In fiscal year 2019 there were 68,925 mammograms per formed, and in fiscal year 2020 there were 64,739 mammograms performed at Tower Health facilities.
Brown said the decrease has been mostly due to the coronavirus pandemic. During the early months of the pandemic, March through May, the hospitals were only performing diagnostic mammograms, which are for women who are experiencing symptoms related to breast cancer.
Now that the hospitals have resumed screening mammograms with proper COVID- 19 precautions in place, extended hours and additional appointments have been added to ensure women canget their annual mammograms.
“We’re trying to play catch- up with women who didn’t get their mammograms during the spring,” Brown said. “We want to encourage women who generally get their mammograms in the summer and fall tomake sure you’re compliant with that because
our fear is not getting your mammogram will delay a possible diagnosis. A year from now, we don’t want to see women who skipped a yearly mammogram and now have a larger abnormality.”
The health system has implemented actions to protect patients from COVID19, which include screening all health care providers and patients prior to entering the buildings, rigorous cleaning and disinfecting protocols, the wearing of proper personal protective equipment for health care providers and face masks for patients and modified appointment scheduling to enhance social distancing.
“We still want people to have their mammograms even though we’re under these COVID- 19 precautions,” Brown said. “We don’t want people to be so conservative with COVID19 that they don’t get mammograms and we end up missing a lot of cancers a year from now.”
Early detection is key
Yearly mammograms are recommended for all women over the age of 40. Though specifics are not known, the risk of breast cancer and other cancers increases with age. The most common age of diagnosis for breast cancer is 65 years old.
“The importance of the mammogram can’t be overstated,” Brown said. “Mammogram gives us a good lead time, probably a one to two years before you would feel the mass in your breast. The difference in survival can be significant.”
Mammograms can detect lumps far smaller than those found during self exams. By the time a woman feels a lump in her breast, the lump is usually the size of a golf ball.
“A stage one tumor is a tumor less than 2 centimeters,”
Brown said. “Mammogram will often find tumors only a few millimeters in size, and the potential cure rate is way over 95% of women with very small tumors on mammogram.”
The number of women getting annual mammograms has increased over the years as the public has become more aware of the importance of mammograms with the help of campaigns such as Breast Awareness Month and around Mother’s Day.
“Getting the word out certainly has saved lives over the past 25 years with mammograms,” Brown said.
Getting a mammogram
Advancements in technology and mammogram machines have made the appointments quicker and more tolerable for women.
“The mammogram has gotten much better over the years,” Brown said. “The new 3D mammograms are a lot more sensitive in picking up early abnormalities.”
During a standard mammogram, two views of the breast are taken. The breast is compressed from top to bottom for one view, and then side to side for the second view.
“You take the images and then the computer sort of slices the images, like a loaf of bread,” Brown said. “You don’t need any extra imaging. Then we’re able to see finer details of either a small mass like a pea or an area of calcifications which have come together that could be an area that’s growing.”
Brown said the small mass and area of calcifications are the two main abnormalities seen on mammograms. Appointments for mammograms are scheduled through the radiology department after receiving an order for one through a physician.
Self checks and risks
In addition to annual mammograms, women of all ages should perform self breast exams and know their risks of breast cancer.
“A general recommendation is to examine your breast once a month, usually in the shower, and you’re looking for something like a marble under the skin, especially something that’s only found in one breast and that is not symmetrical,” Brown said.
If a woman notices a lump in her breast or other changes to the breast such as rash or persistent discharge from her nipple, she should let her health care provider know. Brown noted that a general statement with cancer is that it does not hurt and breast pain often does not mean breast cancer, but the woman’s health care provider should still be informed of the pain so it can be evaluated.
A family history of breast cancer can be a risk factor, though it is not a certainty.
“If you have a high family history of breast cancer, especially with women in your family presenting with breast cancer under the age of 50, you should bring that to your health care provider’s attention because you may be a woman that has a gene for breast cancer,” Brown said. “It’s very rare, most breast cancer is not genetic. Over 85% of breast cancer has no genetic abnormalities with it.”
Women with a high family history can then be followed very closely with MRIs in addition to mammograms.
“Right now we don’t have specifics on who is at risk outside of family history,” Brown said. “All women are at risk, and the best recommendation we have right now in 2020 is yearly mammography.”
Brown has seen women who fall into all different categories be diagnosed with breast cancer.
“I would love the day when we don’t see breast cancer,” he said. “We’re not quite there yet. We just keep doing the research. We have a lot of research programs at Reading Hospital so that we can learn more about breast cancer and how to prevent breast cancer.”
More information on breast cancer is available on Tower Health’s website, www.towerhealth.org, and through the American Cancer Society.