Health First Dr. Firas Muwalla: Take Charge of Your Breast Health and Schedule Your Mammogram
By Health First // October 15, 2020
leading cause of cancer death in women worldwide
It’s easy to put off getting a mammogram. Maybe you don’t have insurance and are concerned about the cost. You’re busy with work and family. Or you’re worried about coming into a healthcare facility and possibly being exposed to COVID-19.
Health First is here to reassure you that we’ve got you covered – safely – and remind you of how important it is to be proactive about your health.
Dr. Firas Muwalla, Medical Director at the Health First Cancer Institute, is here to address your concerns and offer some advice on keeping up with your breast health.
1.) I’m worried about getting COVID-19 if I come in for a mammogram.
“We take patients’ safety seriously,” Dr. Muwalla said. “Appointments are scheduled in a way that assures our waiting rooms, exam rooms and imaging locations are not crowded.”
All equipment and exam areas are cleaned and disinfected based on recommendations from the Centers for Disease Control and Prevention (CDC), as well as our stringent safety protocols.
In addition, patients and visitors entering Health First’s facilities are screened with questionnaires and temperature checks. Per CDC guidelines, masking and social distancing is in full effect.
High-touch surfaces are cleaned throughout the day, and plexiglass partitions are installed to protect patients and associates alike at check-in areas.
2.) Be aware of the stats – and take charge of your own health.
The number one thing Dr. Muwalla wants women to know? Be aware.
“Globally, breast cancer is the second most frequently diagnosed malignancy – just behind lung cancer – accounting for more than 2 million cases per year,” Dr. Muwalla said. “It is the leading cause of cancer death in women worldwide.”
In the U.S. alone, breast cancer is the most common cancer women experience and the second most common cause of cancer deaths in women.
“It accounts for 260,000 cases each year and is responsible for over 40,000 deaths,” Dr. Muwalla said.
3.) What are the risk factors?
When it comes to breast cancer, about 50% of newly diagnosed cases are tied back to known risk factors. An additional 10% are associated with a positive family history.
The risk factors include:
▪Age: The probability of a woman developing breast cancer in the United States between the ages of 50 and 59 is 1 in 42 women, compared to 1 in 14 women 70 years of age or older.
▪ Gender: Breast cancer occurs 100 times more frequently in women than in men.
▪ Race: The highest rate of breast cancer occurs among white women.
▪ Weight and body fat: Obesity (defined as BMI of more than 30) is associated with an overall increase in breast cancer morbidity and mortality, especially in postmenopausal women.
▪ Being tall: Increased height is associated with a high risk of breast cancer in both premenopausal and post-menopausal women.
▪ Estrogen levels: High endogenous estrogen levels increase the risk of breast cancer, particularly hormone receptor-positive breast cancer in both postmenopausal and premenopausal women. This means these particular cancer cells’ growth is fueled by hormones such as estrogenor progesterone.
▪Benign breast disease: A wide spectrum of pathologic entities is included in the category of benign breast disease. Among these, proliferative lesions (a group of noncancerous conditions marked by an increase in the growth of certain cells in the breast) are associated with an increased risk of breast cancer.
▪ Dense breast tissue
▪ Exogenous hormones/menopausal hormone replacement therapy
▪ Reproductive factors: This can include the early onset of menstruation or going through menopause later, as well as never having had children, infertility and being at an advanced maternal age during a first pregnancy.
▪ History of breast cancer: This can be either a personal history of breast cancer or a family history of breast cancer
▪ Inherited genetic mutations: BRCA, p53, STK 11, CDH 1, PALB 2, PT EN, and the mismatch repair genes
▪ Lifestyle factors: Alcohol use, smoking and night-shift work are among the offenders
4.) What are the symptoms of breast cancer?
A breast mass may be associated with:
▪ Breast skin thickening
▪ Nipple deformity/discharge
▪ Skin dimpling
▪ Changes in size and consistency of lymph nodes in the armpit
▪ If the cancer has metastasized, there could be respiratory symptoms (pulmonary metastases) or a headache or nerve, spinal cord or brain function problems, including seizures (brain metastases)
5.) Tell us about the importance of mammograms.
There is more scientific evidence related to screening for breast cancer than any other cancer. Systematic reviews of randomized trials found a significant 15% to 20% reduction in breast cancer mortality with mammography screening for women ages 40 to 69.
“Generally speaking, early-stage cancers are more likely to be cured than advanced stage cancers,” Dr. Muwalla said. “Screening mammography leads to detecting breast cancer at early stages, and therefore saves lives.”
Breast cancer mortality has dropped dramatically since the 1980s.
“This is thought to be related to improvements in breast cancer treatment, as well as screening mammography,” Dr. Muwalla said.
6.) If a woman finds something that seems off, how urgent is it to see a doctor?
Most breast cancers aren’t rapidly advancing malignancies, so there’s no need to rush to the ER. But an evaluation is recommended as soon as possible.
7.) How important is early detection?
Very, which is why screening mammography is recommended.
“Systematic reviews found a 15% to 20% reduction in breast cancer mortality with mammographic screening,” Dr. Muwalla said. “This is at least partly related to early detection.”
In addition to being able to save lives, early detection may allow breast cancer patients to catch their illness early enough so they can avoid chemo after breast cancer surgery.
In countries with established breast cancer screening programs, most breast cancers are diagnosed after a patient’s mammogram is deemed abnormal. However, up to 15% of women are diagnosed with breast cancer after a breast mass is not detected on a mammogram. Another 30% of breast cancers are discovered after a breast mass is detected in between regular mammograms (interval cancers).
8.) What if cost is a concern?
To provide more women access to the healthcare they need, including screening mammograms, Health First is offering this preventive screening for $100 when scheduled during October (and completed by December 31). 3-D Mammography is available for an additional $25.