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Breast cancer awareness campaigns are great, but they should be expanded to provide more clinician education on health disparities and to target women most at risk.
Breast cancer awareness campaigns have been in the top news for many years now. However, activities to promote screening and other early diagnostic tools for breast cancer started to develop in the United States and around the world in the early 1980s. Although most people recognize the importance and effectiveness of these campaigns, some still fail to take the necessary steps for routine screening so that breast cancer, if present, can be diagnosed and treated in the early stages.
Recent controversies regarding the advantages of breast examination and mammography as screening methods for early breast cancer diagnosis have sparked debate in the public sector as well as in the medical community. Regardless, the American Cancer Society still recommends that mammography screening should begin at age 40 and supports the benefits of clinical and self breast examination.
Breast cancer continues to be a public health care problem in the United States. About 1 in 8 US women (approximately 12%) will develop invasive breast cancer during her lifetime. It is estimated that 232,670 new cases of invasive breast cancer will be diagnosed in US women in 2014, along with 62,570 new cases of in situ carcinoma. Of these women, approximately 40,000 will die of their disease. In spite of these alarming numbers, breast cancer incidence rates and deaths have been gradually declining.
Early detection and decreased mortality from breast cancer in recent years has been influenced by public awareness campaigns, screening programs, clinical and personal breast examination, widespread use of minimally invasive techniques for diagnosis, and new therapeutic options. Despite these advances, ethnic and educational disparities exist for diagnosis, survival, morbidity, and mortality.
In general, ethnic minority women are diagnosed with more advanced disease and experience greater morbidity and mortality. Although breast cancer is most common among white women, the disease is most likely to develop in African American women at an earlier age. In addition, African American women are more likely to die from breast cancer.
Among the issues to consider when evaluating different ethnic groups are lack of knowledge about breast cancer; medical care issues, such as insurance, cost, and amount of time spent with a physician; cultural sensitivity of providers; traditions; religious beliefs; language barriers; cultural factors related to beliefs about illness; gender role expectations and family obligations; and social and familial support.
For awareness campaigns to become more effective, it is necessary to implement new strategies that benefit all women in need of high-quality medical care regardless of economic, ethnic, or cultural background. The accomplishment of this goal requires educational programs that focus on cultural and language background of patients, integration of family members as potential key participants in medical decision making, economic support for those without medical insurance, health care support to receive adequate treatment and care after surgery, and the need for health care providers to become more culturally sensitive.
Educational campaigns during Breast Cancer Awareness Month are targeted to the general public. However, efforts should also be focused on educating health care personnel and women's health physicians about health disparities related to breast cancer screening and diagnosis, since these clinicians are the first line of defense in the battle against cancer.
As physicians, we carry an enormous responsibility toward our patients and our role is extremely important in both prevention and treatment. It is crucial to widen these campaigns to involve the medical community and ensure clinicians have more up-to-date information tailored for educating, screening, and treating minority groups. It is ultimately our responsibility to provide patients with a high-quality service that fulfills not only their physical requirements but also their educational and emotional needs.