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October is National Breast Cancer Awareness Month and in preparing to write this blog, I discovered two things – the new classification recommendation for black women and not getting my mammogram last year. I immediately went on my patient portal and scheduled my mammogram and then decided to write about the new classification.

In March of 2018, the American College of Radiology and the Society of Breast Imaging recommended that black women be added to groups considered high risk for breast cancer. This is the first time black women have been classified as a high risk group. Other women considered at high risk for breast cancer are:

• Women with a gene mutation, such as BRCA1 or BRCA2 mutation
• Women who previously had radiation to the chest or face
• Women of Ashkenazi Jewish descent
• Women with strong family history of breast cancer, especially if a parent or sibling has been diagnosed
• Women with a personal history of breast cancer
• Women with dense breasts
• Women with certain benign breast conditions

WHY THE NEW CLASSIFICATION?

Black women and white women are diagnosed with breast cancer at about the same rate; however black women are 20 – 40 % more likely to die from breast cancer. Finding breast cancer early saves lives. Black women experience delays in diagnosis and treatment initiation, which negatively affects survival.

WHAT DOES THAT MEAN TO BE CLASSIFIED IN THE HIGH RISK GROUP?

It means that black women along with other women classified as high risk should undergo risk assessment by age 30. By assessing the risk at this age, a determination can be made whether earlier and more aggressive screening for breast cancer will need to be performed.

WHAT DOES IT MEAN TO GET A RISK ASSESSMENT?

It will include a full review of your history – whether you have a family history of breast cancer, when you started your first menstrual period, whether you have had children, whether you breastfed and may include blood tests. Your physician may choose to send you to a genetic counselor to evaluate your risk.

WHAT CAN ALL WOMEN DO TO LOWER THEIR RISK OF BREAST CANCER?

1. MAINTAIN A HEALTHY WEIGHT – obesity increases your risk of breast cancer when you become menopausal. Even a little bit of weight loss helps to decrease your risk.
2. EXERCISE – There is evidence to show that women who get regular physical activity have a lower risk of breast cancer compared with women that do not exercise.
3. LIMIT ALCOHOL – Drinking alcohol increases the risk of breast cancer. If you have to drink then limit yourself to no more than 1 drink per day.
4. AVOID TOBACCO – QUIT smoking.
5. BE AWARE OF CHANGES IN YOUR BODY – BREAST SELF-AWARENESS – If you feel a lump in your breast, if you notice any bloody nipple discharge or a milky discharge unrelated to breastfeeding and or breast pain unrelated to your menstrual cycle – SCHEDULE AN APPOINTMENT TO SEE YOUR DOCTOR – this is regardless of your age and regardless of whether you had a normal mammogram or recent exam by your doctor. DO NOT IGNORE THESE ABNORMAL CHANGES.
6. GET YOUR SCREENING MAMMOGRAM – For most women this will be yearly starting at age 40, however if you are in the high risk category (see above), it might be younger. If you are younger, a breast ultrasound may be ordered as well because younger women have dense breasts. If you have any symptoms like a lump or pain, you should get a diagnostic mammogram (digital) or a digital breast tomosynthesis. This is different from a screening mammogram.
7. MAKE SURE THAT YOU FOLLOW UP ON YOUR RESULTS. You should know your result within one week of a mammogram. If you do not get your result in a timely manner, call your doctor to get your result. If the result is abnormal, follow up with your doctor immediately, you might need additional testing or may be referred to a breast specialist.

For Breast Cancer Awareness Month, please click here for more information.