Why is October breast cancer awareness month?
Societal attention translates into fundraising, leading to billions of dollars being invested in breast cancer research. These efforts have led to better prevention, diagnosis and treatment of breast cancer.
Why does breast cancer get a whole month? There are over 100 types of cancers out there, and breast cancer only represents about eight of them. But it still gets a lot of attention from huge, multi-day walks, runs and relays, to pink ribbons on every conceivable type of product. In fact, breast cancer is very visible in our society. This attention is definitely warranted. Women make up about 51% of the population, and breast cancer is the most common cancer among women except for skin cancers. While men can be affected, the vast majority of cases are in women. So from a number of points of view, we should be paying attention.
According to cancer.org, “Currently, the average risk of a woman in the United States developing breast cancer sometime in her life is about 13%. This means there is a 1 in 8 chance she will develop breast cancer.” These numbers are for “average risk women” who don’t have a first-degree relative with breast cancer or a known genetic marker that increases risk. For women who carry the BRCA gene mutation, their lifetime risk of developing breast cancer is closer to 60-80%. The genetics behind cancer risk has garnered a lot of attention in the last two decades. Since we have sequenced the human genome, tons of research has been directed at understanding the genetic influences on disease. Many cancers do not have such a clear genetic connection and this is an ever-developing area of research.
I would be remiss if I did not mention the controversy around how “Breast Cancer Awareness” month began. Critics will say that a key driver in its creation was a pharmaceutical company involved in manufacturing breast cancer treatment drugs. However, even though this was part of the impetus to raise awareness around breast cancer, it has certainly gone far beyond these early roots. Now, the movement has been taken up by numerous corporations, charitable organizations, the NFL, and the federal along with state and local governments. The attention has led to hundreds of millions of dollars being raised toward a better understanding of breast cancer. Breast cancer is now one of the most well-studied cancers, and all of the attention translates into more research dollars to investigate how to prevent, treat and/or live with this disease. Simply put, more attention leads to research money, better treatments, and more lives saved.
In addition to the lives lost, breast cancer takes a huge financial and emotional toll at the individual and societal level. Each woman who has a potentially suspicious mass discovered by her physician or mammogram goes through the stress of further testing, the uncertainty of a life-threatening diagnosis and possibly the rigors of cancer treatment. This affects her emotional and physical well-being, impacts her family, and represents financial burdens ranging from healthcare costs to the loss of productivity. Most women know someone who has had breast cancer which makes the reality of this disease hit close to home for all of us. Cynics try to claim that testing and treatment is promoted to make money for insurance and pharmaceutical companies, but this twisted perspective is far from the truth. Screening modalities like mammograms are promoted because the science backs the fact that they are the best tool we have for early detection. Science is always evolving, and we may have better tools in the future. But, for now, the current recommendations are in place to detect suspicious masses earlier and give each patient the best odds at beating cancer.
I think what is particularly difficult about breast cancer is the fact that it can affect women of all ages. The risk of most cancers increases with age because the longer we live, the more likely we are to experience the errors in cell regulation that lead to cancer. However, the more aggressive breast cancers are found in women under the age of 45, which definitely warrants more investigation. Young Survival Coalition reports: “Compared to older women, young women generally face more aggressive cancers and lower survival rates.” The more attention we pay to something as a society, the more resources we will put towards it. So given this information, more research money and awareness will most likely translate into better outcomes, particularly for younger women.
Another reason to pay attention to breast cancer is to understand the many risk factors linked to the disease. Some we have no control over (being a woman, certain genetic factors) while many others can be controlled. As a holistic primary care physician, much of my work is centered around educating and empowering my patients. Our decisions and actions do make a difference. Cancer is one of the most difficult and baffling diseases as the causes are so varied. We know that the BRCA-1 and BRCA-2 gene mutations put a woman at a much higher risk of developing breast cancer. But biology is rarely 100% deterministic, so understanding the role that our own health habits play in developing or preventing breast cancer is very important. Research has made great strides in identifying the best way to diagnose, treat and prevent breast cancer. I’ll write another article that goes into greater depth on how to prevent and beat breast cancer, but for now, the American Cancer Society has a good introduction on risk factors. Prevention and early detection are some of the most powerful tools to improving outcomes for breast cancer patients. One of the original reasons for starting a “Breast Cancer Awareness Month” was to educate women about screening tools like mammography and ensure that we are catching cancers early. According to Dr. Karen Horton, “Breast cancer is curable if detected early and is the second leading cause of cancer-related death in women.” So the attention it garners is well worth the advances in treatment, diagnosis and prevention.
The three pillars of cancer care are prevention, diagnosis and treatment. All these areas have been greatly impacted by fundraising efforts and the public awareness that breast cancer campaigns have raised. The scale of breast cancer research is truly staggering. According to the Breast Cancer Consortium, between private efforts and federal funding, the US spends about one billion on breast cancer research each year. This is a pretty impressive number, and it has surely translated into better treatment and increased survivorship. So next time you see a pink ribbon, remember that 1 in 8 American women will develop breast cancer in her lifetime. I’m sure we could use a few more pink be-ribboned products in our homes this October.