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by MARK POWELL
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Another October is upon us, and with it the familiar pink ribbons donned to draw attention to breast cancer awareness. For the past three decades, Americans have observed Breast Cancer Awareness Month – which is widely considered to be the most visible cancer awareness month of them all.
Yet despite its elevated profile – and despite the pink ribbon having become one of the most recognizable health care symbols in the entire world – many of us still have much to learn about the disease which claimed the lives of an estimated 42,250 women (and 530 men) last year.
For instance, did you know that one in eight American women will be diagnosed with breast cancer at some point in their lifetime?
These statistics are especially sobering in South Carolina. According to data (.pdf) from the S.C. Department of Public Health (SCDPH), some 22,381 cases were reported in the Palmetto State between 2017 and 2021. South Carolina’s new case rate of 133.7 per 100,000 women was slightly higher than the national average of 129.8. Breast cancer also claimed the lives of 3,709 South Carolinians during the same period, translating to 24.1 deaths per 100,000 women.
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Given breast cancer’s seriousness and prevalence – and its preventability – a closer look is now warranted.
“I put breast cancer types into three categories,” noted Amanda Bilko, MD, who is board-certified in hematology and oncology at Lexington Health – an award-winning Midlands-region health care system.
“It’s usually based on what we think is the premier driving force,” Bilko explained. “Hormone-positive breast cancer, the generic estrogen receptor, is the most common. After that, you have the HER2 positive breast cancer. And then you have triple negative breast cancer. Occasionally, someone can have triple positive breast cancer, meaning they’re estrogen receptor positive, PR positive, and HER2-positive.”
Knowing which type of cancer doctors are dealing with is the first critical step in targeting treatment.
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“For example, when you have a HER2-positive breast cancer, we have drugs that target that pathway,” Bilko said. “For triple-negative breast cancer, you don’t have the standard sort of treatment pathways.”
As with any type of cancer, the mere diagnosis can be traumatic to patients. Oftentimes, it is followed by information overload – which can be both confusing and frightening.
“The most important thing when you’re coming to meet an oncologist for the first time is to keep an open mind,” Bilko advised. “We’re approaching things in many different ways in order to tailor the best treatment to each individual patient.”
The most important thing women can do to stay on top of their health is to make sure they are scheduling regular mammogram appointments. According to the U.S. Centers for Disease Control and Prevention (CDC), “women who are 40 to 74 years old and are at average risk for breast cancer (should) get a mammogram every 2 years.”
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“Mammograms can find cancer before it is big enough to feel or cause symptoms,” the CDC noted. “Having regular mammograms can lower the risk of dying from breast cancer. At this time, a mammogram is the best way to find breast cancer for most women of screening age.”
“Be up to date on mammograms,” Dr. Bilko concurred. “And be aware of your family history. Because if cancer runs in your family, you might need to be a little bit more proactive about screening. Also, do self-breast exams. If you notice a lump, please go to your doctor and mention that – because that should always be taken seriously and be evaluated.”
“Sometimes, when the mammogram shows a lump, you need more imaging,” Dr. Bilko added. “And you need to get the biopsy when you see a medical oncologist.”
That’s where specialists like Dr. Bilko enter the picture.
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“Everyone is a little scared at first – everyone’s a little bit uncertain,” she said. “You’re trying to wrap your head around something that is utterly life changing. Plus, you’re getting a ton of information from all these new people you’ve never met before. That’s overwhelming in addition to everything else. So, part of what I do at the very first appointment is say, ‘I don’t really expect or even need you to remember all of this. It’s more just, ‘here’s what you’ve got, here’s what I’m going to do about it,’ and then ‘trust me to make sure I’m doing what needs to be done.’”
In addition to different types of breast cancer, it’s important to remember each type has different stages – which directly impacts treatment plans.
“I start off talking about where the cancer has come from – and then where it is going,” Dr. Bilko said. “Breast cancer that is just in the breast – that’s a low stage, that’s a stage one breast cancer that is essentially either grown big in the breast or it’s gone to the lymph nodes that are nearby the breast. So, it’s clearly trying to move somewhere, but it’s not completely escaped the barn yet, so to speak. That’s stage two or three. And then stage four is a breast cancer that has completely left the breast. For example, it could have gone to the bones, the liver or the lungs. The stage of the cancer is what ultimately determines the patient’s prognosis.”
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As with any type of cancer, the sooner it is detected, the better the chances are for successfully treating it. Even more important is knowing when to start monitoring breast health. The time to start having mammograms depends largely on your family risk factors, according to Dr. Bilko.
“In general, it’s around age 45," she said. "Some experts say 40. It’s that middle-aged area.”
Good health habits can also lead to good breast health. Smoking, drinking, obesity, and lack of exercise can all be contributing factors to the disease.
In short: know your family’s medical history; take care of your health; do routine self-examinations; and if you detect something suspicious, see your doctor immediately. Because in this case, time truly matters.
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ABOUT THE AUTHOR...
J. Mark Powell is an award-winning former TV journalist, government communications veteran, and a political consultant. He is also an author and an avid Civil War enthusiast. Got a tip or a story idea for Mark? Email him at mark@fitsnews.com.
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