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Why Just October?

Writer: goldenstateservicesj
goldenstateservicesj
Oct 14, 2022
5 min read

Ladies, it’s that time of year again. Cooler weather, leaves changing, shorter days, and pumpkin everything. You guessed it! It’s October! And you know what that means…it’s time to consider getting that mammogram you have been dodging all year. But why do we only recognize breast cancer one month out of the entire year? Shouldn’t we think about this every month?

Since 1985, October has been recognized as Breast Cancer Awareness month. This campaign began as a when the American Cancer Society and the Imperial Chemical Industries pharmaceutical division teamed up to educate women about breast cancer, available screening tests, and the importance of “taking charge” of their own breast health. This campaign celebrates breast cancer survivors and those currently battling the disease. It has evolved over time and today, is not only about awareness, but about recognizing social determinants of health that exist creating barriers for many needing care.

 According to the latest cancer statistics reported, there are currently nearly 265,000 new cases of breast cancer diagnosed among women in 2019. The same data also reported that there were 42,280 deaths among women associated with this disease. This cancer is not just limited to women. Although the numbers are significantly smaller, the American Cancer Society estimates that in 2022, 2,710 new cases of invasive breast cancer will be diagnosed in men. But even one case in either gender is too many.

One in every eight women will be diagnosed with some type of breast cancer in her lifetime. This is a staggering figure and because of this, women need to educate themselves on their own personal risk of developing the disease. True, risk factors are often things that can’t be changed, however, there are some lifestyle modifications that can be made to reduce your risk. Here is a list of both:

Factors You Can Not Change

  • Being born female

  • Older age (most at risk are women 50 and older)

  • Mutations of the BRCA1 and BRCA2 genes

  • Early onset of menses (before the age of 12)

  • Late onset of menopause (after the age of 55)

  • Race and ethnicity (white women at a slightly higher risk)

  • Dense breast tissue (those with heterogeneously dense and extremely dense breast tissue at higher risk)

  • Previous diagnosis of breast cancer

  • Diagnosis of some types of benign breast conditions

  • Family history of breast or ovarian cancer (especially in first degree relative)

  • Previous radiation treatment to chest or breast

  • Exposure to diethylstilbestrol (DES)

Factors You CAN Change

  • Alcohol use

  • Smoking

  • Being overweight or obese

  • Sedentary lifestyle

  • Nulliparous (never having children)

  • Taking birth control or hormone therapy associated with menopause

The American Cancer Society recommends that all women be familiar with how their breasts normally look and feel and should report changes to their provider. So, you may ask yourself, “how will I know if I find something I should be concerned about?” This is a question that nearly all my patients ask me when we discuss breast health. Let’s face it, most of us feel lumps and bumps in our breasts, but our insurance is not likely to cover a mammogram or other diagnostic test to relieve our anxiety. There are, however, signs and symptoms that we can remember when determining if this is something that we need to investigate further:

  • Skin dimpling

  • Nipple retraction (new)

  • Change in texture of breast skin

  • Nipple discharge (especially if blood is present)

  • Swelling of all or a part of the breast with or without lump felt

  • Swollen lymph nodes under the arm or neat the collarbone

As a women’s health nurse practitioner with nearly 20 years of experience, I have performed countless breast exams, educated hundreds of women on their breast health, and encouraged all patients to follow screening guidelines in hopes of cancer prevention. After all that time, I considered myself to be an “expert” in this area. But even I didn’t recognize that someone very close to me had the disease. My sister in-law was 38 years old when she had her first and only baby. This was a dream come true for her. She had always wanted to be a mother above all else. She had a great pregnancy, but around her 20th week, she discovered a lump in her left breast. It was small and, at first, she didn’t think much about it. She had experienced breast swelling and tenderness throughout the pregnancy, so this must be normal as well. She asked me and I advised her to let her provider know when she went back for her next visit.  Her provider was also not concerned knowing her history and suggested she have an ultrasound just to be sure. She was relieved when she got the results. It appeared to be benign with its defined borders. They suggested she return after delivery for a second ultrasound just to confirm. The rest of her pregnancy was uneventful, and she eagerly awaited the delivery of her baby girl. About a month or so after delivery, she scheduled the follow-up ultrasound. She had noticed that the lump had continued to grow, but was smooth and, as she was told, the borders were defined which pointed to a benign condition. Unfortunately, that was not the case. The ultrasound revealed a large tumor that had nearly tripled in size since her first visit.  After further testing, she was diagnosed with triple negative breast cancer, a very aggressive type of this disease. This was unbelievable! She was young and had no known family members with a diagnosis of breast cancer.  We lost my sister-in-law within four years. She lived every day to the fullest, spending time with her baby girl in hopes that she would always be able to remember her. She died shortly after my niece’s 4th birthday.

We need to take charge of our own health. We have screening tests available to us, so what is stopping us for saving our own lives? No one is going to take care of me like me. The American Cancer Society provides the following guidelines for women who are at average risk:

  • Age 40 to 44: start screening with a mammogram every year

  • Age 45-54: get yearly mammograms

  • Age 55 and older: mammogram every other year or continue yearly mammograms

There are several programs available to help those that face barriers preventing them from accessing screening tests, including the CDC’s National Breast and Cervical Cancer Early Detection Program (NBCCEDP).

We know that mammograms can detect early breast cancer even in lumps that we cannot feel ourselves. There are not many things that we can control, but prevention is one of them. So, find your prettiest pink ribbon and fight like a girl!

 Resources:

Susan G. Komen Foundation (https://www.komen.org/)

Centers for Disease Control and Prevention Breast Cancer Statistics (https://www.cdc.gov/cancer/breast/statistics/index.htm)

Centers for Disease Control and Prevention National Breast and Cervical Cancer Early Detection Program (NBCCEDP) (https://www.cdc.gov/cancer/nbccedp/screenings.htm#:~:text=CDC’s%20National%20Breast%20and%20Cervical,and%20are%20uninsured%20or%20underinsured.)

Kelley Stallworth Borella, DNP, MSN, WHNP-BC/Assistant Professor

Co-Specialty Track Coordinator MSN Women’s Health Nurse Practitioner Track

Family, Community and Health Systems

UAB School of Nursing

 
 
 

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