Beyond breast Cancer awareness

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By Melissa R. Collum

 As Breast Cancer Awareness Month draws to a close it is more important than ever to be vigilant of the facts and information related to breast cancer. According to the 2022 American Cancer Society statics, in the United States there are 290,560 new cases of breast cancer in women and in Wis. the number of new cases is 5,380. It is important to note that 1 out of every 100 breast cancers diagnosed in the United States is found in a man. Nationwide, deaths in 2022 topped 43,780 and in Wis. there were 720 breast cancer related deaths.  

There is a 90% chance of surviving breast cancer because of early detection and treatment. Nationally, lowest number of deaths, by percentage, are non-Hispanic White women. This is reflective of the number of minority women who are unable to afford both screening and treatment for breast cancer. The highest number of deaths by percentage are Black women. 

According to Tim Clark, Director, Medical Imaging at Crossing Rivers Health in Prairie du Chien “Seventy percent of breast cancer deaths were among twenty percent of women who were not participating in annual screening mammograms.” 

Breast cancer screening means checking a woman’s breasts for cancer before there are signs or symptoms of the disease. One of the first things the United States Preventive Services Task Force (USPSTF) suggests in breast self-awareness. Being familiar with how your breasts look and feel can help you notice symptoms such as lumps, pain, or changes in size that may be of concern. You should report any changes that you notice to your doctor or health care provider. 

The USPSTF recommends that women who are 50 to 74 years old should get a mammogram every two years. Annual screening is recommended for women who may be at higher risk. “Annual screening mammograms are extremely important for early detection,” notes Clark. “Breast cancer is the most commonly diagnosed cancer and the second leading cause of death for women. Early detection is key to the successful treatment of breast cancer.” Although breast cancer screening cannot prevent breast cancer, it can help find breast cancer early, when it may be easier to treat. 

A mammogram is an X-ray of the breast. For many women, mammograms are the best way to find breast cancer early, when it is easier to treat and before it is big enough to feel or cause symptoms. A 3D mammogram (breast tomosynthesis) is an imaging test that combines multiple breast X-rays to create a three-dimensional picture of the breast. If a woman is at higher risk, a breast MRI might be requested by the doctor.  

The Wisconsin Well Woman Program (WWWP) provides certain breast and cervical cancer screening services (mammograms, Pap tests, etc.) at no cost to uninsured or underinsured women, ages 45-64 that meet income guidelines. Women age 35 to 44 with breast symptoms or concerns may also be eligible. There is no premium, co-payment, or deductible for the WWWP. Covered services are available from participating health care providers when enrolled in the program. For WWWP coverage or for more information in Crawford and Vernon Counties contact the La Crosse County Health Department, 608-785-6051, in Grant and Richland Counties contact the Juneau County Health Department, 608-847-9373. 

Not only is it important to be aware of the medical issues related to breast cancer, it is also important to be aware of laws and regulations related to diagnosis and treatment. The Wisconsin Breast Cancer Coalition (WBCC) is an advocacy group founded in 1994 working with the National Breast Cancer Coalition (NBCC), to raise funds and awareness about breast cancer in Wis. The WBCC lobbies on both Capitol Hill and in the State House fighting for federal and state legislation and funds for breast cancer treatment. Since its founding over $45 million dollars has been awarded to Wisconsin institutions for breast cancer research. 

In 2017, Wisconsin joined many other states in passing legislation that required health care facilities to notify a woman, after her mammogram, if she had dense breast tissue. The mandated notification also encourages women to follow up with their health care professional to discuss risk and the potential need for further screening. 

Unfortunately, many insurers do not cover the cost of screenings beyond the initial annual mammogram. If a woman cannot afford the cost of additional, necessary screenings, she may choose to forgo them entirely. This increases her risk for an undetected cancer to spread and become more lethal before her next annual mammogram. Not covering additional, necessary screenings causes a disparity in access to potentially lifesaving healthcare for the 40% of women in Wisconsin with dense breast tissue. 

 Wisconsin State Senate Bill 413 and Assembly Bill 416 were introduced in June 2021. This bill requires health insurance policies to cover, either fully or with a maximum out-of-pocket cost of $50, essential breast screenings beyond mammography in individuals who have had mammograms showing dense breast tissue, women who are at higher risk for cancer, or women whose health care provider considers the screenings to be medically necessary do an above-average risk for breast cancer in accordance with certain guidelines. In March 2022, the Wisconsin Legislature the bills failed to pass the Senate and Assembly. 

Efforts by state legislatures to defund Planned Parenthood and shutter women’s health clinics are part of the incredibly contentious political debate. Women’s health clinics can offer services like cancer screenings and treatment for conditions ranging from diabetes to anemia. Efforts to defund or close these clinics could have adverse consequences for all aspects of women’s health beyond reproductive health. Studies show a direct correlation between women’s preventative wellness screenings, detection in treatable diseases, and the closure or decrease in funding of women’s health clinics. 

The importance of Breast Cancer Awareness month goes beyond a ‘reminder’ to get your annual exam. It is an important reminder to consider all aspects, both physical and political, of health and wellness. 

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