Preventing Breast Cancer

orget the color of fall leaves, October is a month flush with pink thanks to the ubiquitous ribbons symbolizing National Breast Cancer Awareness Month. That's why October is a prime time for women to commit to better breast health by doing self-exams and getting regular mammograms.

The American Cancer Society recommends that women begin getting regular mammograms beginning at the age of 40. Women who have an increased risk of developing breast cancer should begin their mammograms earlier. For example, a daughter should begin getting mammograms around 5 to 10 years before the age that her mother was diagnosed with breast cancer. However, regular mammograms before the age of 25 are not encouraged. 

"The main risk factors are being a woman and getting older," says Dr. Lewis A. Jones, JR., director of Breast Imaging at McLaren Greater Lansing. "If you are overweight, particularly if you have post-menopausal weight gain, you're at risk. Women who decide not to have children are at risk. Women who have their first child after 35 are at a slight increased risk of developing breast cancer."

In 2008, only 68 percent of Black women over the age of 40 had had a mammogram in the previous two years, according to the Centers for Disease Control and Prevention. Some women perceive a mammogram as too painful, while others worry about the amount of radiation necessary for the procedure, and some women are just plain embarrassed.

But Jones says the mammogram procedure is not as scary as some make it seem. "There's a machine that's maybe about 4 or 5 feet high and it's got compression plates. You walk up to the machine and they typically take two views of each breast," Jones says. "The actual mammogram procedure shouldn't be anymore than a couple of minutes. There's going to be a little bit of pressure because they have to have good compression. If you're not feeling anything at all, you're not getting a good study."

Although Black women have a lower incidence of Breast Cancer than White women, they are more likely to be diagnosed with larger tumors, and the mortality rate is significantly higher. According to the American Cancer Society, the mortality rate for African American women was just over 32 percent from 2003-2007, this compared to nearly 24 percent for Caucasian women.

Researchers have yet to determine the cause for black women's higher breast cancer mortality rate, but there are some factors that are suspected to play a role.

"[Women] have certain ER/PR receptors, that are more positive in white women. There are more negative ER/PR receptors in black women, and therefore it's harder to treat," Jones says. "Women who have ER/PR receptors that are positive can be treated with hormonal therapies like Tamoxifen. Black women in general just have a higher degree of negative receptors."

Other factors such as later detection, suspected institutional racism and lack of health care could also contribute to the African American breast cancer mortality rate. Organizations such as the CDC's National Breast and Cervical Cancer Early Detection Program, offer access to mammograms to qualifying women.

"Money shouldn't really be an issue with getting mammograms because there are a lot of programs that can help women afford to have their mammograms without paying anything at all or paying very small rates," Jones says.

Although mammograms aren't recommended until around the age of 40, pre-menopausal women are encouraged to remain aware of their breasts through what is now called "breast self awareness."

"The whole idea behind breast self awareness is just to let the women know what their breast feel like from month to month," Jones says. "Look in the mirror, look at the way they're shaped, if there is any discoloration, if there are any indentations, and then just feel around the breast in a somewhat methodical fashion. Of course if you notice something different, that's when you go talk to your doctor."

"You want to use the pads of the middle three fingers, and just gently go over the breast with mild pressure at first, then go around again with deeper pressure and then third, very deep. You want to make a circle around the breast, and make smaller and smaller circles until you reach the nipple. You also should examine underneath the armpit to see if there are any abnormalities"

Dr. Jones says that the reality is that all women are at risk of developing breast cancer. The illness doesn't discriminate against age or race. So whether it's through breast self awareness, a breast examination or a mammogram, every year the month of October serves as a reminder to all women to take steps to reduce their risks.