Breast cancer is the second leading cause of cancer deaths in women in Rhode Island after lung cancer. Lung cancer is almost always fatal but is essentially a preventable disease associated with the use of tobacco. Breast cancer, on the other hand, when detected early, is highly curable.

Approximately one in ten women will have breast cancer at some point in her life. Hispanic and Asian/Pacific women have a lower incidence than non-Hispanic white women. However, African-American women have a 10% higher incidence than white women. Although breast cancer can occur before the age of 40, the risk increases with age, with the highest risk in women over 70.

Cancers detected early, when they are still small and self-contained, are highly curable. It is important for women over the age of 16 to initiate a regular breast health program. Every woman should learn how to examine her own breasts at least once a month. This can be done while she is in the shower with her fingers gently feeling the texture of the breast and being aware of its changes during her regular cycles. Clinical breast examination by a health professional should be part of her annual physical examination.

It is now clear that regular mammograms can find early breast cancer. This has contributed to a significant increase in the cure rate. It is recommended that every woman over the age of 40 have an annual screening mammogram. Women with a high risk of breast cancer may need to start their mammography earlier than age 40. This includes women who have a first-degree relative (mother, grandmother, sister) who developed breast cancer before menopause. Women whose families have a history of ovarian cancer may also be at a somewhat higher risk for both ovarian and breast cancer.

All insurance companies in Rhode Island cover the cost of annual mammograms for women over the age of 40 and high risk women who are younger. Medicare will pay for an annual mammogram for all women over the age of 65. For uninsured and underinsured women over the age of 50, the State has a grant from the Centers for Disease Control and Prevention (CDC) to cover the cost of screening mammograms and Pap smears. This program is extended by the Chafee bill to include treatment, and has been implemented in Rhode Island by Governor Almond. For uninsured women under the age of 50 who require screening mammogram, the State initiated a program last year to make screening mammograms, and any other diagnostic studies that may be required, available to women who are uninsured or have little insurance. This program is administered by the State Health Department with funds from the Rhode Island Cancer Council.

Rhode Island women have a very high mammography screening utilization record, ranking in the top ten states in the country, but Medicare figures show that only about half of women over the age of 65 are having regular mammograms. This is the population of women who are at an increased risk of breast cancer and, therefore, should not be neglecting the prospect of early detection. It may very well be contributing to our higher than average death rate from breast cancer. Furthermore, although we have a small African-American population (about 4%), their experience with breast cancer has been very bad with a death rate one-third higher than white women.

It is important to initiate a breast health program post-adolescent and carry it through a woman's entire life. It can save her life. Self-examination and clinical breast examination are important in that they can find small lesions as big as a thumbnail; mammograms can detect lesions when they are as small as a pinhead. All women in Rhode Island now have access to a complete breast health program from adolescence through the rest of her life. With early detection and care we can reduce the burden of breast cancer in Rhode Island.

For more information and answers to specific questions contact the Rhode Island Cancer Council at Tel@ricancercouncil.org or call us at (401) 728-4800 or toll free 866-879-4100.

IT IS EASIER TO PREVENT CANCER THAN TO TREAT IT.

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