As we enter month eight of the COVID-19 pandemic, I’m going to remind everyone that it is still important to wear a mask, wash your hands and social distance. The topic for this month is breast cancer awareness. As with most of our activities during these last few months, some of our patients haven’t been getting their mammograms done on time. We’re getting back on track, but the rest of this article will discuss why that is so important.
One in eight women will have breast cancer in their life. It is the most common cancer in American women. The current estimate is that almost 42,000 women will die from breast cancer this year. There is some good news in current statistics: death rates are down 39% from 1989 to 2015. This is thought to be due to better screening and better treatment. Identifying the disease early does improve outcomes.
Screening for breast cancer is done with a mammogram. While not a comfortable test, it is not invasive and provides valuable information. The current recommendation is for women between 50 and 74 years to have a mammogram at least every 2 years. My patients often come in with letters from the radiology locations stating that they are due for their “annual” mammogram. We usually have a discussion about the current guidelines and come to an agreement that they are comfortable with following. This recommendation is rated as a “B” level recommendation. This recommendation is backed by evidence and should be followed.
For those between 40 and 49, screening should be individualized. If a patient is at risk for breast cancer, screening mammograms should be offered every two years. Those risks include being over-weight, not having a completed pregnancy, drinking alcohol, smoking and not getting enough exercise. Women with a family history of breast cancer should also be counseled about starting mammogram screening early. There is risk of starting mammograms early because of false positive tests and extra procedures that may not be necessary.
For women 75 and older, there is no good evidence that mammograms should be continued. Our approach is to consider a woman’s overall health before suggesting that breast cancer screening should continue. This is definitely an individual decision.
Men are also at risk for breast cancer. It is rare, but does happen. Those with a family history of breast cancer should discuss this risk with their physician. Men should also be aware of their bodies and report any lumps, bumps or swelling in the breast area.
At HealthTexas, breast cancer screening is one of our quality measures. We do our best to have all of our eligible patients undergo the appropriate screening, health and risks. If you are 40 or over, please talk with your physician about a screening mammogram. If you don’t have a primary care physician, consider one of the physicians of HealthTexas. We all work to practice the same, high-level of care.
Michael Dominguez, MD, FAAFP is board certified in Family Medicine. His office is located at HealthTexas Medical Group, 590 N. General McMullen, 78228, phone: 210-249-0212.