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IHS Observes Breast Cancer Awareness Month

by Capt. Celissa Stephens, Director, Division of Nursing Services, Office of Clinical and Preventive Services, Indian Health Service

October is Breast Cancer Awareness Month, an annual observance to increase awareness of breast cancer risks, screening and treatment options.

Breast cancer is a disease where normal cells within the breast or surrounding tissue become abnormal, begin to multiply and eventually form a tumor. According to the National Breast Cancer Foundation, Inc. one in eight women within their lifetime will be diagnosed with breast cancer. In the United States, breast cancer is the most common cancer in all women regardless of race or ethnicity.

Compared with other ethnic groups in the U.S., American Indian/Alaska Native (AI/AN) women have the lowest incidence of breast cancer and yet, have the lowest breast cancer survival rate of any ethnic group in the U.S. Breast cancer is the third most common cause of death from cancer among AI/AN women (after lung cancer and colorectal cancer). 

There are different types of breast diseases that range from benign (non-cancerous) to malignant (cancerous) that often present with different symptoms. For example, breast pain and nipple discharge are often symptoms of benign or non-cancerous breast diseases. While most breast disease is benign, it is very important for women to discuss breast symptoms with their health care provider, who will then determine their risk and the need for additional tests such as a screening mammography (mammogram). 

The most recognized symptom of a breast malignancy or cancer is a distinct lump or a thickening that is felt in the breast tissue. The risk factors for breast cancer include: 

  • Age: risk increases with age
  • Genetic factors (inherited changes in certain genes including BRCA1 and BRCA2)
  • Long-term use of hormone therapy
  • Obesity
  • Low levels of physical activity

A screening mammogram is an x-ray of the breast and surrounding breast tissue. The main goal of a screening mammogram is to find breast disease before symptoms start (such as a lump that can be felt). The mammogram is the best way to detect breast cancer in its earliest, most treatable stage, and can detect cancers too small to be felt during a clinical breast examination. 

All women should inspect their breasts and be aware of how their breasts normally look and feel.  If a woman finds a lump or notices a change in the appearance, shape or thickness of their breast it is very important that they schedule an appointment with a healthcare provider.

Although most breast lumps are non-cancerous, the only way to be certain is to have a screening mammogram. If a woman’s mammogram is abnormal, the healthcare provider will often order additional tests such as, an ultrasound or MRI (Magnetic Resonance Imaging) of the breast to obtain a clearer, more detailed view. If a solid lump is detected the healthcare provider may also recommend a breast biopsy, which is relatively painless procedure. During a breast biopsy, a small needle is inserted into the suspicious lump to remove cells which are then sent to a laboratory to determine if the cells are cancerous.  

It is important to know that a woman at average risk for breast cancer may not have a personal history of breast cancer, a strong family history of breast cancer, or have had chest radiation before the age of 30. For this reason, the American Cancer Society recommends: 

  • Women between 40 and 44 have the option to start screening with a mammogram every year.
  • Women 45 to 54 should get mammograms every year.
  • Women 55 and older can continue to choose to have yearly mammograms or can elect to have them every other year. Screening is recommended as long as a woman is in good health with a life expectancy of 10 more years or longer.

Women who are determined to be at high risk for breast cancer by their health care provider should get an MRI Exit Disclaimer: You Are Leaving  and a mammogram every year.

What can women do to reduce their risk of breast cancer? While breast cancer cannot be prevented all women can reduce their risks by:

  • Maintaining a healthy weight
  • Being physically active
  • Increase fruits, vegetables, and whole grains
  • Moderate consumption of alcohol
  • Avoid smoking

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Capt. Celissa Stephens, Director, Division of Nursing Services, Office of Clinical and Preventive Services, Indian Health Service
Capt. Celissa Stephens, MSN, BSN, RN, is the Director of the Division of Nursing Services, Office of Clinical and Preventive Services at IHS Headquarters in Rockville, Maryland. She leads, develops and manages clinical and public health nursing services, such as acute care, ambulatory care, women’s health, public health nursing, emergency care services and the HIV/AIDS Program.