Education and Advocacy: Turning Breast Cancer Awareness Into Action

October has turned pink for breast cancer awareness. This year, an estimated 310,720 new cases of invasive breast cancer — the second most common type of cancer and the second leading cause of death for US women — will be diagnosed.^1,2 The Breast Cancer Awareness Month (BCAM) annual campaign that promotes early detection and facilitates fundraising to support research and treatment plays a critical role in educating patients about the benefits of breast imaging and reducing mortality rates. Still, there’s more work to be done in demystifying myths and improving access.

“Early detection of breast cancer through annual mammograms is critical to saving lives, but more than 40% of US women report skipping screenings,” says Erik Anderson, division president of breast and skeletal health solutions for Hologic. “We want women to fully understand the importance of getting screened and remove any barriers and misconceptions around breast cancer and mammograms so they can prioritize their health.”

Recent FDA regulations that require mammography facilities to notify women about their breast density has fueled concern about screenings, risk, and follow-up exams. Also this year, changing guidelines from the US Preventative Services Task Force (USPSTF) for average-risk women — from screening biennially with mammograms by age 50 to age 40 — led to some general confusion about recommendations in light of the American Cancer Society’s stance that women aged 40-54 should have the option of annual screening.³ 

“In the news, there’s always talk about changes in guidelines for screening recommendations. Guidelines change, and the different organizations often don’t agree,” says Nina Vincoff, MD, medical director for the Katz Institute for Women’s Health and division chief for breast imaging at Northwell Health. “That noise tends to overshadow the most important message that everyone agrees on: Screening saves lives.”

Understanding Risk Factors

A key BCAM message is that women’s screening guidelines are not “one size fits all.” For women to determine an optimal screening plan, they must work with their primary care providers or OB-GYNs to learn their risk profile, determined by numerous factors including breast density, family history, race and ethnicity, and lifestyle choices.

“We can’t just say 40 and over is appropriate for everyone. We really need to be looking at the individual risk factors for women,” says Christie Devine, product manager of women's health for Siemens Healthineers North America.

“In mammography, we don’t see you until 40,” agrees Dr Vincoff. “But if you’re high risk, it may have been appropriate for you to have your first exam at 25 or 30,” she says, noting that both the American College of Radiology and Society of Breast Imaging call for all women to have a risk assessment by age 25.

Additionally, breast cancer risk and survival vary by race and ethnic group,⁴ as disparities remain for Asian American, Pacific Islander, Native American, and Black/African American women, says Kemi Babagbemi, MD, associate professor of clinical radiology at Weill Cornell Imaging, noting mortality rates among Black/African American women are nearly 40% higher than in White women.

“I want Black and other minority women to feel empowered and not afraid to ask for a life-saving risk assessment to see whether they need to get mammograms earlier than 40 as well as whether they need other supplementary imaging like MRI with their usual mammograms depending on their risk status. Knowing your risk is power,” Dr Babagbemi says. “Black and minority women are still more likely to die from breast cancer so we need to continue to give them the information to self-advocate.”

“Breast cancer should not be considered a death sentence. Early detection is key to survival as the earliest, localized cancers have a 5-year survival rate greater than 99%, so there’s no need to fear,” Dr Babagbemi continues. “And even if [women] are afraid, they can still come and get their mammogram. We must not let fear stop us from doing the thing that could save our life.”

Highlighting Industry Outreach

Original equipment manufacturers (OEMs) are sharing supporting materials for BCAM in various forms. Hologic’s #BustTheMyth campaign dispels common misconceptions around breast cancer and mammograms, letting women know what to expect from exams and how to find providers, says Anderson. Siemens has created a Web site to provide downloadable awareness materials and help clinicians and women better understand dense breast tissue, notes Devine.

In September, GE HealthCare outlined key details around the density reporting standard on their Web site, along with the importance of supplemental screening technologies. Also last month, Beekley Medical and Fujifilm Healthcare hosted their first Breast Imaging Education Summit on topics like contrast-enhanced mammography, artificial intelligence in screening, and targeted ultrasound of lesions identified on mammography and MRI. Fujifilm is also sponsoring a PBS Breakthrough Women in Science and Medicine episode about breast density’s new guideline featuring Rachel Brem, MD, director of breast imaging and intervention, and professor of radiology at The George Washington University Medical Center.

Maintaining Access and Advocacy

While provider and patient education are important during BCAM, that’s only part of the mission, says Dr Vincoff.

“Awareness and education are great, but now we’re [focused] on access,” she says. “That’s the challenge of this next phase of making an even bigger impact in breast cancer: ensuring that women have access to the testing they need.”

Hologic, Fujifilm, and Siemens support mobile mammography programs that promote women’s health, raise awareness about early detection through screening, reach underserved areas, and empower women.

“The reasons why women can’t or don’t get screened are numerous, so we are really proud to partner with our valued customers to bring that screening service to our community,” says Devine.

While mammography access and education are improving, availability of supplemental screenings and associated costs remain a barrier in some areas and populations.

“The Affordable Care Act (ACA) enabled millions of women to access cost-free screening mammograms, but supplemental imaging options beyond a mammogram often involve out-of-pocket costs. Ensuring coverage for these diagnostic and supplemental screenings is an important driver of our continued advocacy efforts to help women access personalized care,” says Jyoti Gupta, PhD, president and CEO of women’s health and x-ray for GE HealthCare.

Investing in Technology

OEMs continue the fight against breast cancer by investing in technologies that improve detection for radiologists, workflow for all clinicians, and comfort for patients.

“You only have 5 minutes to make an impression on the patient and make sure that they come back next year,” says Devine.

As technology advances image quality and screening capabilities for better outcomes, radiologists will continue to drive home a simple but crucial motto every month of the year: Successful protection lies in early detection.