October is Breast Cancer Awareness Month: Early Detection is Critical to Better Outcomes
One in eight women will be diagnosed with breast cancer and three percent (or 1 in 39) will die from the disease in their lifetime. Think about that number as you look around. Breast cancer is the most common cancer in women in the United States, except for skin cancer. Certain factors increase the risk of breast cancer including increasing age, family and personal history and ethnicity. While we hear a lot about the role of genetics in breast cancer, only 10 percent of breast cancer patients have an identifiable genetic cause, so screening is important for all women.
Early detection and treatment are critically important to better outcomes. Established guidelines recommend that screening imaging start at age 40-50 and continue on a regular basis for those at average risk. Upland Hills Health uses 3D screening because it is the most sensitive for those of average risk. Those at higher risk may need to start screening earlier and may benefit from supplemental imaging, such as screening MRI. Separate from routine screening, anyone with breast concerns or symptoms should be promptly evaluated.
Understanding personal breast cancer risk is critical in establishing personalized breast health care. All women should undergo an initial breast cancer risk assessment between the ages of 25-30, which should be updated yearly. Upland Hills Health has incorporated these assessments into annual wellness visits throughout the primary care clinics utilizing the Ambry Genetics CARE program (https://www.ambrygen.com/partners/care). Women with strong family or personal risk factors may have a greater than 20 percent chance of developing breast cancer over their lifetime, and understanding personalized risk can empower women and their physicians to develop individualized screening plans. Using this same risk assessment model, women who qualify for genetic testing can also be identified and the testing can be initiated on-site if desired. Some women who undergo genetic testing may be found to be at even higher risk for breast cancer. For example, a BRCA gene mutation may be associated with a 45-87 percent chance of developing cancer. Identifying those genes can be life saving for both patients and their relatives, who may then be found to carry the same genes.
Upland Hills Health is a member of the National Consortium of Breast Centers and participates in their quality improvement program, the National Quality Measures for Breast Centers. This voluntary program tracks and measures quality performance metrics on more than 30 separate indicators. Through participation in this program, national quality benchmarks in breast care are established and allow for direct comparison of outcomes with breast centers of all sizes across the country. We continually use this data to assess our performance and guide our improvement efforts. As a critical access rural breast center, Upland Hills Health is unique among participating breast centers. Nevertheless, we continue to see outcomes that confirm our commitment to providing quality health care in the community. For example, our breast cancer detection rates are comparable to screening detection rates at larger institutions across the country. Additionally, Upland Hills Health performs at the highest levels for familial risk assessment and genetic testing, two very important factors in establishing personalized cancer risk management.
Upland Hills Health and the community that supports it can be very proud of the investment they have made in breast health. It demonstrates the importance that the health system and the community place on each individual and their personalized care, which are extremely important in breast cancer prevention, screening, and treatment.
Dr. Jared Linebarger is a surgeon at Upland Hills Health. He completed a Fellowship with the Society of Surgical Oncology in Breast Surgical Oncology at Emory University in Atlanta, Georgia.
