Recent updates from the United States Preventive Services Task Force (USPSTF) have stirred discussions within the medical community regarding breast cancer screening protocols. The updated guidelines call for biennial mammograms for women 40 to 74 years of age at average risk for breast cancer. Those inside and outside of government should applaud this effort. That begs the question of what it means for 75 and older women, whose screening benefits are still eligible to be unknown.
Our research has shown that women 74 and older might be left out of screening recommendations, even though screening could provide health benefits. Now, healthcare professionals are voicing alarm about the absence of guidelines. They argue that carefully nuanced approaches to breast cancer screening are needed in older patient populations. They maintain that an arbitrary one-size-fits-all approach only focused on age does not take into account people’s health profiles and risk factors.
The influence of lifestyle factors on breast cancer risk deserves special attention. There are few topics in cancer research that are as well-established as the connection between alcohol intake and higher breast cancer risk. Yet a new study published today in the Journal of Women’s Health paints a troubling picture. Women who have one daily alcoholic beverage see their breast cancer risk increase by 10%.
Demographically varying rates of diagnosis strengthen the idea that breast cancer is a complicated disease. Dr. Ko’s research found that non-White women are significantly more likely to be diagnosed with stage III locally advanced breast cancer than White women. At the same time, it raises emphasis to improve access to early detection and treatment across the board.
Allies in the healthcare community have long lobbied for taking action early, beginning in childhood. You can start discussing these options with your healthcare provider by age 25. Talk to someone about your own risk factors, such as your family history of breast cancer and when you started your period. If you have a significant family history, your doctor may recommend genetic testing. This simple mutation test identifies mutations in the BRCA genes, which can increase breast cancer risk.
The National Cancer Institute offers a risk calculator that can assist individuals in assessing their breast cancer risk based on various factors. In addition to genetic evaluations, routine exercise is highlighted as an important focus of cancer prevention. Dr. Ko recommends 150 minutes of moderate exercise per week and emphasizes how crucial it is to staying healthy and preventing disease.
For example, breast cancer incidence continues to increase until roughly age 70. After this, women aged 70 and older are significantly more at risk compared to their younger counterparts. Dr. Hendrick notes, “We know that the incidence of breast cancer continues to increase up to about age 70 and is still high for women over 70, compared to young women.”
While progress in treatment has resulted in mortality rates for breast cancer decreasing—43.5% since their peak in 1990—disparities continue to exist. Black women have higher breast cancer mortality rates—39% higher—compared to their White counterparts. Recent research from the Fred Hutchinson Cancer Center highlights an alarming trend: the rise of triple-negative breast cancer among Black, Hispanic, and Asian or Pacific Islander women over 65.
When compared to other subtypes, triple-negative breast cancer has the lowest five-year survival rate. It still haunts us with its cruel treatment needs and devastating outcomes.
Advocates urge Americans to get empowered, involved in their care and demand patient-centered, whole-person care. Dr. Ko advises, “I would encourage patients: Find people that treat you like you matter, and go to them and hang on to them.” She emphasizes that understanding one’s medical history is paramount: “Know your history – genetic history, cancer history, personal family history – and risk factors.”
Scientists and advocates, medical providers and patients, are changing the dialogue on breast cancer screening. They’re on the front lines fighting to close gaps in equity and spread proven prevention strategies. As these guidelines go into practice, there is an urgent need for patient and provider education on both sides.
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