Dr. Janine Pettiford, who practices surgical breast oncology at Northside Hospital, shared the importance of mammogram screenings to save lives at the Sandy Springs Perimeter Chamber’s Signature Luncheon.
“I know women are scared about the radiation. You can get more radiation from flying from here to California on a one-way trip,” she said at the Oct. 31 event at Sandy Springs City Hall.
Black women have a 40 percent higher mortality rate despite roughly equal incidence rates, Pettiford said. They have a two-fold higher risk of aggressive triple-negative breast cancers, are less likely to be diagnosed with but twice as likely to die of Stage I breast cancer and are more likely to present with advanced-stage cancer.
Hispanic women have a 20 percent higher mortality rate despite lower incidence rates, Pettiford said.
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A lack of access to care and mistrust of the medical community may be the cause of the disparities in treatment of Black women, Pettiford said. She said that treatment delays and even screening delays caused by the COVID-19 pandemic are among the causes.
To reduce the disparities, she said patients need to work closely with their primary care physician. Awareness and education need to be increased to let patients know resources are available to help fund screening and other diagnostic mammograms. Access to care must improve and women who are at high risk for breast cancer need to be identified, Pettiford said
Pettiford said many patients ask about plant-based diets, which are fine, but warned women to monitor their intake because many special diets have a lot of soy and tofu in them, which contain a lot of hormones.
“And we know those hormones can drive breast cancer,” Pettiford said, noting that eating a well-balanced diet is important.
Insurance coverage has increased, with the Oncotype DX test now mandated to be covered by all insurance plans in Georgia, Pettiford said. That is important because many patients would not get the testing done because it wasn’t covered and cost up to $5,000.
Insurance companies cannot deny BRCA testing because of pre-existing conditions, she said. The BRCA gene test looks for changes to DNA that increase the risk of breast and ovarian cancer.
As 15 percent of breast cancers are not seen on imaging, doctors must rely on ultrasounds and MRIs as well, she said.
To lessen the risks of breast cancer, Pettiford said to limit alcohol consumption to less than one drink per day, exercise, and control your weight. Women 40 and older should get yearly mammograms, she said, citing recommendations from the American College of Radiology and the American Cancer Society.
Those at high risk should begin screening 10 years younger than the youngest affected relative, with semi-annual clinical exams. Breast imaging should be done every six months beginning at age 25, alternating between MRI and mammography.
Breast cancer is detected 85 percent of the time it is present with a screening mammogram That’s why it is important to do monthly breast examinations, Pettiford said.
