By Catherine Tucker, M.D., and Vicki MacLean, N.P.
Medford and Stoneham – Surgical Oncology – Breast Surgery
After discovering that Malden and Medford have high rates of late-stage breast cancer, Dr. Tucker and her team are seeking ways to improve women’s health in the community.
The Susan G. Komen Foundation looks at every state and the stages of breast cancer diagnosed within the states. What they found within the Massachusetts state breast cancer registry was frightening: Medford and Malden have extremely high rates of late-stage breast cancer.
Obviously, our team was furious. Day in and day out, we support patients as they get mammograms and fight cancer. To see these high numbers made us stop and think: What are we doing wrong, and what can we do to fix it?
Let’s take a closer look at the stages of breast cancer, how this happened in Medford and Malden, and what our team is doing about it.
What are the stages of breast cancer?
Like all cancers, staging is an important part of breast cancer diagnosis. It helps doctors determine their patients’ treatment options. Maybe a woman won’t need a mastectomy because her tumor is small, or maybe she can avoid chemotherapy because the cancer hasn’t spread to the lymph nodes.
There are five stages of breast cancer:
- Stage 0, sometimes called pre-cancer. This cancer is almost always curable.
- Stages 1 and 2 are considered early stage. These stages are treatable and have a 5-year survival rate of 93 percent to 100 percent.
- Stage 3 is more advanced, with a 72 percent 5-year survival rate.
- Stage 4 is metastatic, which means the cancer has spread and has become a chronic condition. It has a 22 percent 5-year survival rate.
The Susan G. Komen Foundation pointed out that, within Massachusetts, Medford and Malden were in the highest groups for instances of Stage 3 and Stage 4 breast cancer. State statistics, adjusted for population size, indicated that Medford had a 16.5 percent late-stage presentation – patients’ breast cancer wasn’t discovered until it became advanced or metastatic. Compared with Boston, which was at 15.9 percent, that’s a significant number of late-stage cases.
Adding to our anger, Medford fell into the top 10 Massachusetts cities in which women die of breast cancer at a younger age. Data from the Massachusetts Breast Cancer Coalition indicate that the breast cancer rate in Massachusetts was nearly 12 percent higher than the national average in 2012.
Why the high rates, and what are we doing about it?
After calming down and taking a close look at the data, we uncovered three major reasons why Medford and Malden have high rates of late-stage breast cancer:
- Limited access to mammograms. The Medford and Malden area is a fairly well-insured area, so it comes down to when and where mammogram appointments are available.
- Misunderstanding of when to start. With all of the mammography guideline updates over the past few years, women just don’t know when to start mammograms. Also, not every woman can safely start mammograms in her 40s – some need to start much earlier.
- Doctors who aren’t persistent enough. Some doctors simply don’t believe that mammography saves lives, so they don’t push their female patients to start getting them. This is very disconcerting to us as we serve the women in our community.
It’s our responsibility as providers to do what is best for our patients. When we don’t help women get in the habit of annual mammograms at the appropriate age, we’re risking their lives and limiting their treatment options if cancer does develop. The further the stage at discovery, the fewer and more radical the breast cancer treatment options become.
With all the confusion around the mammography guidelines updates, it feels like we’re asking, “How much is a woman’s life worth?” Breast cancer often strikes randomly, and there are a lot of women at risk here. If we only screen the high-risk women, we’ll probably miss 75 percent of the cancers. We can’t get cocky and assume the way we’ve always done it is what will work – because obviously it isn’t.
My team is working with local providers and administrators to make sure we all understand how important these statistics are and to develop a plan – quickly – to improve the breast health of women in our community.
Becoming more flexible with when we offer mammography in Malden and Medford is a good first step. We’re working on a plan to potentially include:
- Saturday appointments
- Later clinic hours
- Mammography clinic days
We can’t think about breast cancer just during October. Breast cancer awareness is not a fashion statement or a marketing scheme for pink clothing or ribbon-branded snacks. It’s about a serious disease that takes the lives of too many women in our community who could have been saved with annual mammography.
Tags: breast cancer, breast surgery, cancer, cancer prevention, women's health