By Cmdr. Diane Hite and Cmdr. Jason Wong, Office of Women’s Health at the Navy Bureau of Medicine and Surgery. Hite is a Navy Nurse. Wong is a Navy Obstetrician Gynecologist.
We would like to share a personal story of a Navy colleague and friend, who spoke with us candidly about her journey with breast cancer. In 2007, Valerie was diagnosed with breast cancer. She was given multiple options and decided on surgical intervention and reconstruction. She has not doubted the choices she made to save her life and encourages women to get a mammogram for early detection. She believes that could be the best day of their life, because they would be afforded options allowing them to be in control of decisions to survive. Her comment to us was women should seize the moment, for today is the day to make an appointment for your mammogram!
So what raises your risk for breast cancer? Well, getting older is associated with higher risk, as well as not having children, having children at an older age, starting menstrual periods at a young age, or beginning menopause at a late age. In addition, having a close family member experience breast cancer (such as a mother, sister or daughter) or having a personal history of breast cancer and/or other breast disease also increases your risk. If any of these apply, you may consider gene testing including BRCA 1 and BRCA 2 (ask your doctor for more information). In addition, using any form of hormonal treatment including birth control pills, or hormone replacement therapy after menopause may increase your risk. Not being healthy -poor diets, being obese, drinking alcohol, and not exercising certainly increases your risk too! It’s obviously a lot to remember, so talk to your provider who can easily assess your risk for breast cancer and make recommendations for screening.
What you can do to prevent breast cancer? First is staying healthy including getting regular exercise, maintain a healthy weight, and being sensible about how much alcohol you drink helps to minimize your risk. You should also get an annual clinical breast exam by your provider. Is there a test to detect breast cancer? Yes, there is. Mammograms are the best tests to detect breast cancer early. The X-ray picture can show breast tumors much sooner than you or your health care provider can find them on exam (up to three years sooner). Breast cancer is usually highly curative when caught at a smaller or earlier stage, so having both an annual clinical breast exam and a mammogram at least every other year starting at age 40 is the best strategy to beat breast cancer.
So what barriers keep a woman from getting mammograms on a routine basis? The top barriers in women’s words are:
- “I don’t need a mammogram because my doctor has never recommended I have one.”
- “I’ve never thought about it.”
- “I have no breast problems, so mammography isn’t necessary.”
- “I don’t have enough time.”
- “I have had a mastectomy (double mastectomy, radical mastectomy) and don’t have breasts.”
- “I don’t have a family history of breast cancer”
Other barriers include:
- Fear about pain from the procedure.
- Fear of a diagnosis of breast cancer.
- Concerns about screening costs.
- Concerns about the financial burden of diagnostic procedures and treatment, if needed.
- No recent clinical breast examination or Pap test.
- No routine source of health care.
- Difficulty taking time off from work to be screened.
- Living a far distance from the screening site.
- Sources: The Manual of Intervention Strategies to Increase Mammography Rates, Centers for Disease Control and Prevention with the Prudential Center for Health Care Research.
A common misperception is that you don’t need a mammogram if you don’t have any family history of breast cancer.
There’s been a lot of press lately about mammograms, and if and when women should get them. Fortunately, the Navy just issued guidelines late last year. Mammogram screening is indicated for all active duty women at age 40 and above after having a respectful candid discussion with your health care provider. Screening should be at least every other year after that, and more often depending on your health risk factors, values, and the recommendations of your provider.
So don’t wait until tomorrow, make an appointment today.
Check out these websites for some useful information:
American College of Obstetricians and Gynecologists- New Guidelines for Breast Cancer (Jul 2011): http://www.acog.org/from_home/misc/spotlightOnBreastCancer.pdf
National Breast Cancer Awareness Month Website: http://www.nbcam.org/
More information on Breast Cancer and Prevention-Center for Disease Control and Prevention: http://www.cdc.gov/cancer/breast/basic_info/screening.htm
American Cancer Society: http://www.cancer.org/Cancer/BreastCancer/DetailedGuide/breast-cancer-prevention