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Survivors And Doctors Stress Importance Of Mammograms

Christina Fernandez, 64, of Dallas loves to wear pink every October to honor survivors, remember those lost to the disease, and to support the progress made to defeat breast cancer. She’s a breast cancer survivor herself and Parkland Health & Hospital System providers describe her as a great example of hope and strength.

“I always try to wear something pink, like a shirt or socks,” said Fernandez.

Her journey began in 2005 when she was diagnosed with stage 1 breast cancer. She now has metastatic triple-negative breast cancer and is receiving hormonal therapy and chemotherapy at Parkland.

“I started getting mammograms at age 35 after my friend developed breast cancer at 28,” said Fernandez. “Even so, I was surprised when I was diagnosed at age 48, because nobody in my family had breast cancer.”

According to the Centers for Disease Control and Prevention (CDC) breast cancer is the second most common cancer among women in the United States. In 2018, 254,744 women were diagnosed with breast cancer and 42,465 women died of the disease. Death rates have been going down, but disparities persist. The rate of new breast cancer cases is highest among non-Hispanic White women. Death rates are highest among Black women and Hispanic women are not far behind.

However, when diagnosed early, experts stress that breast cancer is highly treatable. Almost 99% of women diagnosed with breast cancer at the earliest stage live for 5 years or more, compared to about 27% of those diagnosed at the most advanced stage. In addition, breast cancers diagnosed at an early stage are much less expensive to treat than those diagnosed at a late stage.

There are different symptoms of breast cancer, and some people have no symptoms at all. Symptoms can include:

  • Any change in the size or the shape of the breast
  • Pain in any area of the breast
  • Nipple discharge other than breast milk (including blood)
  • A new lump in the breast or underarm

“We recommend women start receiving annual screening mammograms at the age of 40, as research shows this saves 70% more lives than waiting until the age of 50 and screening biennially. These are guidelines for women at average risk for breast cancer,” said Jessica Porembka, MD, Medical Director, Breast Imaging at Parkland. “Our data show that about 16% of Parkland patients were diagnosed with breast cancer before age 45 and about 34% before age 50. Parkland sees breast cancers in younger patients due to the population served. Our goal is to detect a cancer when it is as small as possible, long before it is palpable.”

Parkland’s 2019 Community Health Needs Assessment (CHNA) found that racial disparities in breast cancer in Dallas County are devastating. Nationally, the breast cancer death rate was 40% higher for Black women compared to White women even though the incidence of breast cancer is actually lower in Black women.

The CHNA discovered that compared to the rest of the county, several zip codes, predominantly located in South Dallas, have the highest rate of breast cancer morbidity and mortality and are known to experience the highest rate of socio-economic health disparities. Patients with breast cancer from these areas who are treated at Parkland present with late stage disease at twice the U.S. rate, Dr. Porembka said. To help identify women at high risk, Parkland deployed a data-driven cancer screening campaign to increase the number of breast health community events within the target Dallas ZIP codes (75210, 75211, 75215 75216, 75217, 75241, 75060, 75243, 75061) and in several other areas of the county where women are at higher risk.

Approximately 44,000 patients receive breast health services each year at Parkland. The opening of the new Moody Center for Breast Health in February marked a major improvement in access to care. From screening and diagnosis to surgery, medical oncology, genetic counseling and recovery programs, the center brings together under one roof the vital breast cancer services previously scattered at 10 different Parkland locations while also offering state-of-the-art clinical care.

“Some of the important risk factors for breast cancer are beyond a woman’s control,” said Dr. Porembka. “But there are many lifestyle choices women can make to lower their risk, such as weight loss, increasing physical activity, reduced alcohol consumption, smoking cessation and choosing to breastfeed your children.”

Women should be familiar with how their breasts normally look and feel and should report any changes to their doctor right away. According to the American Cancer Society, most often when breast cancer is detected because of symptoms (such as a lump), a woman discovers it during usual activities such as bathing or dressing.

“There is no need to be afraid of getting a mammogram,” Fernandez said. “Are mammograms the most pleasant thing? No. But it’s not like getting a shot or something. The providers are patient and they make you feel comfortable. If I can help someone to be less afraid and schedule a mammogram, then that’s a win for me.”

Parkland’s annual “Come Together for the Cure” Breast Cancer Awareness Symposium will be held virtually via Facebook and WebEx from Oct. 4 – 8 at 11 a.m. in English and 1 p.m. in Spanish. The event will feature discussions on breast self-exams, breast cancer facts and myths, plus stories from survivors. To join the event, click here. The video will also be uploaded to Parkland's YouTube account.

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