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COLDWATER - As part of Breast Cancer Awareness Month, medical experts and breast cancer survivors and patients shared insights on screenings, detection and treatment options during a specialized panel in Coldwater on Monday.
More than a dozen women attended the October installment of Mercer Health's education series, which presented "Beyond the Mammogram: Understanding Breast Health and Your Personal Risk," a roundtable discussion about the most common cancer among women in the United States aside from skin cancer.
Jessica Bergman, a certified nurse midwife, Dr. Megan Core, a primary care provider, both at Mercer Health; Kendra Seitz, a two-time breast cancer survivor; Allie Gross, a breast cancer survivor; and Dayna Kramer, a breast cancer patient, spoke about which screening options exist, what the screening guidelines are, how to be self-aware, and the importance of leaning on the community.
"Importantly, this is the most common type of cancer that women tend to get," Core said. "About 1 in 8 is the lifetime risk for developing breast cancer over any woman's lifetime. We also know that if we find breast cancer early, then, thankfully, our outcomes are really good."
Core and Bergman explained the different screening options, including a mammogram, a breast ultrasound and a breast MRI.
A 3D mammogram combines low-dose X-ray images into a detailed 3D picture of the breast, per the American Cancer Society. Those tests have fewer false positive results, but are less sensitive for women with dense breasts, or breasts that contain more tissue than fat. A mammogram is more effective when the person has fattier breast tissue because the white tumors stand out more against the dark background, Bergman said.
A breast ultrasound uses sound waves to make a picture of the inside of the breast, per the Centers for Disease Control and Prevention. The test can be used in addition to the mammogram and helps cut through the density of the breast. It is less expensive than a breast MRI, but it can result in more false positives.
A breast MRI is the best detection test, though it is reserved for high-risk patients as it is expensive. The test uses magnets and radio waves to take a picture, per the CDC.
Screening recommendations vary from organization to organization, though all evidence supports that, at a bare minimum, women aged 50 should get a mammogram every other year until they are 75 years old, Core said.
For example, the American College of Radiology recommends yearly mammograms starting at 40. The American Cancer Society recommends yearly mammograms for women ages 40-45. The United States Preventive Services Task Force recommends a mammogram every other year for women 40-74. The American College of Physicians recommends one every other year for women 50-74.
Women should consult with their primary care provider, who may consult different sources. A yearly test can provide assurance, though it is an added expense.
"When they've done the data, looking at yearly versus every other year, the outcomes are really the same," Core said. "The survival rates, the early detection rates, they're really very equivalent."
Bergman and Core both agreed that excessive screening can create more false positives, which can create increased health anxiety and unnecessary biopsies.
Similarly, the science is moving away from regular self-exams, as the research does not support them. Instead, women should have breast self-awareness, or know what is normal versus what is not.
"They used to really push every month around the same time of your cycle doing a self-breast exam in the shower or in your home," Core said. "Those, really, in the research too, did not prove to be useful at all and resulted in increased false positives."
A woman knowing her breasts and what is typical is more useful, per research. If she notices a new lump or hard knot, changes in size and symmetry, skin dimpling, nipple inversion or nipple discharge, she should contact her provider,
"A lot of breast cancers are diagnosed by women themselves," Core said. "Seventy-one percent of women under 50 identify their breast cancer on their own and 50% of women over age 50."
Seitz, of Maria Stein, found a lump and followed up with her doctor.
"It was almost like a fluke that you find this lump," she said, "I never did the self-exams, unfortunately. I had nipple discharge."
She was 29 when she was first diagnosed with breast cancer, and an MRI determined the cancer was stage 0, she said. She chose to have a double mastectomy, and when she was 32, it came back as stage 1. She did chemotherapy and radiation. When the doctor performed the double mastectomy, they routinely keep extra fat at the side in case the woman wants reconstruction, and that was where the cancer was the second time.
Gross, of St. Marys, also found a lump herself when she was nursing her child.
After receiving a mammogram, an ultrasound and an MRI, she chose to have a mastectomy in addition to chemotherapy, radiation and immunotherapy.
Bergman also said women are at a higher risk for breast cancer if they have certain genetic mutations, including BRCA 1 and BRCA 2, have a history of chest radiation or have a history of breast cancer.
Because her mother had invasive ductal carcinoma when she was 49, Kramer started receiving mammograms when she was 25 or 30 years old.
"(In) March of this year, I was just in the shower, washing my armpits like I do every day, and I found a lump. I thought, 'Here we go,'" the Chickasaw resident said.
After a mammogram, an ultrasound and a positive biopsy, she had a double mastectomy on April 28 and started chemotherapy on June 1. Her last treatment was Sept. 9, and she recently had 25 lymph nodes taken out of her left armpit. Her next steps include radiation and immunotherapy.
"It's not a group you want to be a part of," Gross said, but added, "I think we're really supportive."
To remember lost loved ones and honor current patients and survivors, the eighth annual Paint the Pavement Pink is set for 11 a.m.-1 p.m. Saturday at Marion Township Park.
For more information, visit Paint the Pavement Pink's Facebook page.
To calculate a personal breast cancer risk assessment, visit magview.com/ibis-risk-calculator/.
