October in Vermont is bittersweet. The warm days and lingering light of summer are gone, but in their place is the earthy smell of fallen leaves and that first fire in the wood stove. The early darkness prompts the lighting of candles and the whole scene is cozy and warm. October is also is Breast Cancer Awareness Month and as the season turns and the fray of the holidays approaches, it’s perfect timing to ensure you’re up to date with preventative care including your mammogram.
One in eight women will be diagnosed with breast cancer in their lifetime, making breast cancer the most common cancer diagnosis in the U.S. Breast cancer is the second most common cause of cancer death behind lung cancer. Despite these spooky statistics, there is lots of recent news to celebrate in breast cancer. For example, the death rate continues to drop approximately 1% a year and the survival rate for local breast cancer (Stage 1) is 99.1%. This is directly attributable to early detection through mammogram and other imaging techniques and the opportunity to intervene when cancers are small and early.
Regular mammography reduces the risk of dying from breast cancer significantly. According to a recent study of over half a million women, those who skipped even one scheduled screening before a breast cancer diagnosis faced a substantially higher risk of dying from the cancer. By contrast, the incidence of breast cancers proving fatal within 10 years of diagnosis was 50% lower for participants who did not skip a screening. Compared to women who attended only one of what should have been two previous screens, those who attended both had 29% fewer breast cancer deaths.
Why is this so important now? During the peak of the Covid-19 pandemic, many hospitals and clinics suspended screening services, and large numbers of women missed their annual mammograms. According to the Prevent Cancer Foundation, an estimated 35% of Americans missed their routine cancer screening due to COVID-19-related fears and service disruptions. As we work towards our new normal, we need to get those people back in the screening rooms as quickly as possible.
As breast imaging has evolved, so have the recommendations on when to start mammogram and how to best evaluate breast tissue. For normal risk women, the American Society of Breast Surgeons (the governing body to which Dr. Olmsted and I belong) recommends annual mammography beginning at age 40. For women at higher risk, MRI and/or mammogram can be recommended as early as age 25.
Traditionally, the cost and expertise required to offer this advanced care has required women in rural areas to travel to larger medical centers away from home. At Copley, thanks to the generosity of our many donors, we now have a permanent MRI here with plans to add a breast coil soon and are in the process of purchasing a stereotactic biopsy machine for our breast center. The addition of this stereotactic machine is an incredible advance for us – it allows for identification and removal of precancerous cells before they can form into a tumor.
Women put off mammograms for many reasons. Some worry about the discomfort. Some worry about costs, especially with a test that is generally recommended every year. For many of us, however, we worry about hearing that there is something unexpected or concerning and what that means for us, for our families, and for our futures. The indisputable benefit of regular, early mammogram is that when we do find abnormalities, they are much more likely to be curable.
Cancer is scary to think about and given how common breast cancer is, most of us know someone who has been diagnosed with and treated for it. We are very lucky here at Copley to have excellent resources to treat breast cancer. From our evolving radiology resources with the stereotactic machine and breast MRI and our well-established ultrasound biopsy program to oncology/infusion services to two general surgeons with special interest and expanded training in breast cancer surgery, excellent breast cancer screening and care is available to you, close to home.
As Breast Cancer Awareness Month winds up, we encourage you to schedule your mammogram and take advantage of the exceptional care available here at Copley.
(Dr. Waterman Manning is a board-qualified general surgeon. Dr. Olmsted is a board-certified general surgeon. Both are proud members of the American Society of Breast Surgeons, the primary leadership organization for general surgeons who treat breast disease.)
 Breastcancer.org, Breast Cancer Facts and Statistics
 National Cancer Institute SEER Program, seer.cancer.gov
 American Cancer Society, Study Finds Missing Regular Mammogram Increases Risk of Death from Breast Cancer, March 2, 2021