Recovering the Sacred: Breast cancer awareness paramount among Native women
Special to First Nation’s Focus
One in eight women in the U.S. will get breast cancer during their lifetime. And while incidents of breast cancer is lower in Native women compared to non-Native women, breast cancer is the most frequently diagnosed form of cancer among Native women and the second leading cause of death.
What’s more alarming is that Native women are being diagnosed at a younger age than other women. On average, a Native woman will be diagnosed around 57 years of age versus 63 years of age among white women.
Native women are less likely to be screened for breast cancer compared to other women and thus, more likely to die of breast cancer than other women. Only 60% of Native women 40 or older have had a mammogram done in the past two years versus 69% of black women and 65% of white women.
Studies have shown that when a diagnosis of cancer is made, the cancer is already in a later stage among Native women; and in fact are 4 times more likely to be diagnosed with stage 4 triple-negative breast cancer than women of other ethnicities.
The fact that Native women are not receiving breast cancer screening, getting breast cancer at a younger age, and are likely to be at a more advanced stage when diagnosed makes routine screening and understanding of the risks all the more important for early diagnosis, treatment and survival.
Mammogram screening is important for all women. Along with follow-up testing and treatment if diagnosed, mammography can reduce the chance of dying from breast cancer.
Among Native women, barriers to breast cancer screening include: low income, lack of access to care, different health care provider at every visit, lack of recommendation from the provider to get mammogram screening, lack of knowledge of breast cancer risks and fear of bad news or fear of pain with the procedure due to lack of understanding of the screening procedure.
Average risk screening guidelines
• Women ages 40-44 have the option to start annual breast cancer screening.
• Women ages 45-54 annual mammogram recommended.
• Women age 55 and older may switch to mammograms every 2 years.
Screening should continue as long as a woman is in good health and is expected to live at least 10 more years.
High risk screening Guidelines
A woman is considered to be high risk for breast cancer if:
• She has a BRCA1 or BRCA2 gene mutations.
• Is a first-degree relative of a BRCA carrier, but untested herself.
• Has had radiation to the chest between the ages of 10 and 30 years.
• Has Li-Fraumeni , Cowden, or Bannayan-Ruvalcaba syndromes or is a 1st degree relative.
• Has breast tissue with high density.
For women at higher risk:
• Screening may begin before age 40
• It may be recommended that women at higher risk have an annual MRI screening done as well.
There is no sure way to prevent breast cancer, but there are things women can do that might lower their risk:
• Maintain a healthy weight. Both increased body weight and weight gain as an adult are linked to a higher risk of breast cancer after menopause. The American Cancer society recommends that women avoid excessive weight gain by balancing food intake with physical activity.
• Eat a healthy diet. While the studies are not clear on how a healthy diet can lower the risk of breast cancer; a diet low in fat, low in processed and red meat and high in vegetables and fresh fruit clearly has proven benefits on weight and lowering the risk of other diseases.
• Be physically active. Moderate to vigorous physical activity is linked to lower breast cancer risk, so it is important to get regular exercise. The American Cancer Society recommends that adults get at least 2 ½ hours of moderate physical activity or 1 ¼ hour of vigorous activity a week.
• Limit or avoid alcohol. Alcohol has been shown to increase the risk of breast cancer. The American Cancer Society recommends that women who drink have no more than 1 alcoholic drink a day.
• Breastfeeding. Women who choose to breastfeed for at least 3-6 months get the added benefit of lowering their risk of breast cancer.
• Birth Control and Hormone Replacement Therapy. Most studies have shown that the use of birth control pills place a woman at higher risk of breast cancer. Hormone replacements containing estrogen also place women at higher risk of breast cancer, especially if used after menopause.
The decision to have breast cancer screening done, when to start screening and how often to have screening should be determined by the woman with help from her provider. Her provider can help the woman to make an informed, values-based decision. It is helpful if the woman asks her provider about the procedure itself to reduce any concerns or fears she may have.
We can all can help raise awareness of Native breast cancer by celebrating Indigenous Pink Day in October and encouraging loved ones to get their screening done and by spreading the word that mammograms along with early detection and treatment can save lives.
“Recovering the Sacred” is a monthly women’s health-focused column from Rebecca Chavez (Western Shoshone), who is a certified nurse-midwife, women’s healthcare provider and a mother of two. If you have any questions or ideas for future topics, email her at firstname.lastname@example.org.