I hate to say this but it’s true: I am about five months behind on having my mammogram this year. I have my doctor’s order tacked on the calendar in the kitchen and I keep moving it as the months turn over.
So, why have I, a woman over 40, put off doing something so important? I could tell you that I do my regular self-exams and I haven’t found any lumps or other anomalies that would send me flying to the telephone. I could tell you that I eat well, don’t drink alcohol and exercise regularly.
Mostly — and this is the excuse that until recently I held most dear — I could say that I don’t have a family history of breast cancer. Neither my mother, nor maternal or paternal grandmothers, aunts, etc. have had the disease.
I could say these things but I won’t because frankly none of these things eliminates my risk of developing breast cancer, especially the last reason. According to the American Cancer Society, 80 percent of women diagnosed with breast cancer have no family history. Does that amaze you? It amazes me.
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Last October, the Chicago-based Sinai Urban Health Institute released a study that said African-American women in Chicago were 68 percent more likely than white women to die of breast cancer. That rate is astounding and higher than in New York City.
In March, a large group of smart people from hospitals and government agencies across Chicago and the nation started culling information to figure out why there’s such a disconnect. The Metropolitan Chicago Breast Cancer Task Force began by looking at the disparity in access to quality mammograms and quality treatment.
On Wednesday the group will discuss findings and recommendations to close the gap at Rush University Medical Center.
The disparity has a host of contributing factors, including those related to poverty and misinformation. Poor women often have to endure grueling clinic experiences, which makes even thinking about going to the doctor off-putting. Many poor women also are subjected to less-than-the-best-quality mammograms and treatment.
“A lot of women believe that if a mammogram is normal, then they’re done,” said Dr. Alejandra Perez-Tamayo, surgical director of Mercy Medical Center’s breast care center. Mercy is a member of the task force.
“But aggressive breast cancers, particularly in younger women, are not always picked up on mammograms.”
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However, they may be detected with a breast exam by a trained professional. This means the mammogram and the breast exam go together.
But here’s something else: Genetics also contribute to the disparity. What doctors have known for some time is that African-American women have genetically more challenging breast cancers than white women, even when the cancers are discovered at about the same stage. It’s not entirely clear why. Researchers do know that the bad cells in black women’s breasts divide more rapidly and seem to have a more aggressive nature. The moral of this story is that this is a multifaceted fight, but the system can be designed to better serve Chicago’s women, and that’s what the task force hopes to do.
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But we all have to be more vigilant. That includes those of us who don’t have any apparent risk factors, or impediments to quality health care.
There’s a still better reason why I should know better about delaying my mammogram. Beyond the statistics, the studies, the cartload of information I’ve thumbed through over the years, I’ve seen the ravages of breast cancer up close.
My mother-in-law — an incredibly smart and talented black woman — died of the disease in 2005. Watching someone you love slip away after her body and mind have been ravaged by a cancer that started in her breast should provide the perfect incentive to be more vigilant. Clearly it doesn’t always.
I resolve to do better. We are all busy and have many reasons to put off making the appointment to have a mammogram. (And as of Oct. 1, all uninsured women in Illinois can have free mammograms and breast exams under a state program. Call 888-522-1282.)
So here we are: Let’s make a pact to make an appointment. By the way, I made mine last week. No more excuses, right?
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