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'Cancer Prevention & Screening' posts

Health Disparities and Breast Cancer

Just as all breast cancers are not alike, the impact of breast cancer is not the same for all women. African American women are less likely to get breast cancer than Caucasian women, but they are about 40% more likely to die of it when they do get it. African American women are also more likely to be diagnosed with breast cancer at a younger age than Caucasian women and to have more advanced cancers at diagnosis.

There appear to be multiple reasons for these disparities - including cultural beliefs / misperceptions about screening and cancer; lack of access to screening; inequities in healthcare delivery and treatment; concerns about being exposed to racism by healthcare institutions; and biological differences in the cancers themselves.

Let’s look at some of these more closely.

  • Cultural beliefs / misperceptions about ....

Are you or someone you know at risk for lung cancer and should you be screened?

As lung cancer awareness month approaches us in November, we think about what lung cancer risk means to ourselves, friends, family members, and our patients. Many don’t know that lung cancer is the leading cause of cancer deaths in the U.S., far surpassing the rates of other cancers like breast, colon, and prostate.

What’s the risk of getting lung cancer?

The health risks from cigarette smoking are considerable and pose the largest risk for lung cancer; more than any other risk factors combined. Men who smoke are at 23 x the increased risk and women at 16 x the risk for lung cancer. This lung cancer risk is directly correlated with the concentration of (numbers of cigarettes smoked each day) X (number of years smoked).

Fortunately, the number of those who have quit smoking is growing, but sadly, more than half of all newly diagnosed lung cancers today are occurring in former smokers or non-smokers. People who have quit smoking remain at continued risk for lung cancer and there is also concern about lung cancer in second-hand smoke exposure.

The positive news on lung cancer is that two large multicenter research trials have been conducted in the past 12 years. The Swedish Cancer Institute was a major study site for one of these trials in association with Seattle Radiology. These trials have very clearly and consistently shown significant benefit in the early detection of lung cancer with low dose CT scan, reducing lung cancer mortality by 20%.

Who should be screened and how?

Understanding who is at risk for lung cancer is helpful but identifying...

What you should know about breast cancer and tips for reading online information

Since October is Breast Cancer Awareness Month, I’ve been paying more attention to online blogs about breast cancer and realize there is a lot of information and misinformation out there. How can you know what’s correct, what’s marketing, and what is just plain wrong? Here are some tips:

  1. Be an aware and questioning reader: Ask yourself some of the following questions. What is the source of the information? Does the author have anything to gain financially from the information? Are there studies that provide data supporting the recommendations? Who funded the studies and were there any potential conflicts of interest?
  2. Investigate more than one source: Healthcare has become very politicized and complicated but you can find reliable sources. But realize even with trusted sources the information provided may be conflicting. Some reliable sources include: Swedish Cancer Institute, Breast Cancer Action, National Cancer Institute, and American Cancer Society.

  3. Don’t be taken in by conspiracy theorists: I have practiced surgery for 30 years in a variety of situations and healthcare institutions and NEVER have I experienced a desire to withhold effective tests and treatments from patients. Physicians and hospital systems are not suppressing tests, treatments, and /or cures in order to stay in business. I don’t know a breast surgeon who wouldn’t be thrilled to have to practice another specialty if there was a way to prevent breast cancer.

Here are some things that I think it is important to know about breast cancer:

Issaquah Run Benefits Swedish Cancer Institute In Issaquah: Join Team Swedish Issaquah

The Rotary Club of Issaquah has selected the Swedish Cancer Institute/Issaquah as the primary beneficiary of their 36th annual 5/10K run/walk event.

All of the funds that go to the Swedish Cancer Institute will be put in a special fund for patients being cared for at Swedish/Issaquah. We know this fund will fill a vital need, allowing Swedish to continue to provide charity care and other resources to patients needing the support.

We would love to have a strong showing at the Issaquah Run, so I encourage you to join team Swedish Issaquah!

Race details:
Issaquah Run
Sunday, Sept. 30
10K Run, 5K Run/Walk & Kids Run

To register for our Swedish Issaquah team, please click here. This link goes directly to our team page, and you must use this link to join the team.

Swedish employees and “friends of Swedish” get $5 off registration. The code for Swedish is SMCRUN and will provide a $5 discount; staff can use this code when registering.

We hope you participate in this important community event and support the Swedish Cancer Institute. For more information and general details about the Issaquah Run, visit www.issaquahrun.com.

Do self breast exams matter?

Self breast exams: to do or not to do?

Remember when there were monthly emails you could sign up for to remind you and your friends to do your self breast exams at home? Remember seeing the news anchors talking about their monthly self breast exams in an attempt to remind you to do your breast “due diligence?” What happened to self breast exams and are they still important?

Initially, self breast exams were recommended as a screening tool to help early detection of breast cancer. Unfortunately long-term studies have not confirmed that they actually live up to their hype. Two large studies looking at over 200,000 women in both Russia and China didn’t show any difference in breast cancer mortality after 15 years between the women who were performing routine self exams and those who were not. In fact, the women that were practicing self exams found more lumps and underwent more biopsies for benign reasons. Reviews of several other studies failed to show a benefit of regular breast self-examinations including no benefit of early diagnosis, or reductions in deaths or stage at diagnosis. Hence in 2009, the US Preventative Services Task Force advised that clinicians no longer recommend routine self breast examination as a screening tool for breast cancer detection.

Even though you don’t need to be doing a monthly self exam, you should...

What test is best for breast screening?

I often get asked why can’t a woman just get a breast MRI rather than a mammogram. The imaging tests that we do for breast cancer screening and evaluation of abnormalities have different strengths and weaknesses.

Mammograms are very useful as a screening tool. They can be done quickly and read efficiently by the breast radiologist. They have minimal radiation exposure. They can be done by a mobile coach in locations that are more convenient to patients. They are excellent for identifying abnormal calcium deposits within the breast tissue and for seeing disrupted tissue and masses. They may be less effective in women who have dense breast tissue but the digital techniques have helped some with that. 

Ultrasound is a great tool for evaluating a mass or tissue asymmetry found on mammograms. It can distinguish between a benign appearing solid mass, a fluid filled cyst, a mass that is suspicious for cancer, or normal appearing breast tissue. There is no radiation exposure. It is less reliable as a screening tool because it can be dependent on the skill of the physician or technologist doing the procedure. It is possible to miss abnormalities or to mis-interpret normal findings as abnormal. There are studies underway evaluating using an automated version of ultrasound as a screening test but the results are not conclusive and this is not considered ready for standard practice.

Breast MRI is a highly sensitive test that is very dependent on...

Getting a mammogram

Frequently women will ask me: Where should I get my mammograms? There are several things to think about.

First, you want to go to a Center that is accredited by the American College of Radiology. This means that they have high quality images and well-trained radiologists. It is preferable to have a digital mammogram but if that technology is not available, then film mammograms are better than not having one done. While it is not clear that digital mammograms improve survival, they do allow the radiologist to examine the images more clearly and to use computer assisted diagnostic tools.

The radiologists’ experience is also important. Dedicated breast centers usually have radiologists who are specialized in breast imaging. These sub-specialized radiologists are very experienced in using mammograms, ultrasound, and breast MRI to diagnose breast disorders and are less likely to miss abnormalities.

Convenience is also a consideration. You want to make it easy to get your mammograms. Some Breast Centers will have mobile mammography programs that will bring mammogram screening to your place of work, local community or senior center, or even your church or synagogue. If possible, it is a good idea to get your mammograms at the same Center or within the same hospital system every year. That way the radiologists have easy access to your prior studies and can compare them to the current ones.

Here are some other things to know about getting mammograms:

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