Dr. Larry Norton
To recognize the beginning of Breast Cancer Awareness Month, Memorial Sloan Kettering Cancer Center (MSK) today shared five tips to help women navigate the prevention, diagnosis, and treatment of breast cancer during the COVID-19 global health crisis.
About one in eight women in the U.S. will develop breast cancer in their lifetimes, including more than 320,000 women who will be diagnosed this year. Medical experts fear cancer deaths will climb in 2020 as the COVID-19 pandemic forced people to stay home, leading to a dramatic drop in mammograms and other important screenings that detect cancer early and improve the chances of effectively treating – and often curing – the disease.
“Considering the challenges presented by the pandemic, it’s easy to see why so many women would think twice about travelling to visit a doctor or a screening location,” said Larry Norton, MD, Medical Director of the Evelyn H. Lauder Breast Center at MSK. “But the risks of untreated cancer greatly outweigh the risks of infection in a quality medical setting. If you want to stay healthy, our message is loud and clear: Make sure you get your annual breast screening, tell someone if you have a lump or other symptom, and conscientiously adhere to any treatments underway.”
MSK shared the following tips:
Hospitals are safe; Don’t forego your screening or cancer treatment
During the pandemic, 40 percent of adults in the U.S. have delayed or avoided medical treatment, and as a result, cancer screenings have plummeted. Appointments for screenings for cancers of the cervix, colon, and breast were down between 86 percent and 94 percent in March when COVID-19 forced many people to stay home, according to data from Epic, which tracks personal health records. To reduce an uptick in breast cancer diagnoses, it’s crucial for women to receive their regular mammogram screenings.
Like MSK, hospitals around the country have taken substantial steps to ensure safe in-person visits, and we encourage all women to resume their mammogram schedule and not postpone scheduled cancer treatment without consulting their care team. “While we all recognize that social distancing is one of our best tools for controlling this pandemic, cancer has not sheltered in place,” Dr. Norton said. “Cancer needs to be diagnosed and treated properly. People can remain safe while still obtaining screening and cancer care. We want people to focus on the totality of their health – not just avoiding the virus but minimizing the dangers of cancer too.”
Advances mean less invasive treatment
In cancer treatment, less is often more. Breast conserving surgery allows women to have less invasive procedures, avoid hospitalization, and get back to their daily lives sooner. Chemotherapy, historically considered a cornerstone of breast cancer care, may no longer be necessary for women with intermediate-risk breast cancer. Oncotype testing allows women who are eligible to avoid this additional step in treatment.
When chemotherapy is needed, it can help shrink tumors before surgery, allowing for a less invasive procedure. “Over the years, treatment approaches for breast cancer have become more tailored to the individual patient, which can mean treatments that are more easily tolerated and quicker recovery times,” said Monica Morrow, MD, Chief of the Breast Surgery Service at MSK. “Cancer treatment is never a walk in the park, so whatever we can do to make surgery and needed treatments easier on patients – while not sacrificing our ability to cure the disease – is critical.”
Keep on top of your exercise regime
Although gyms are only beginning to reopen and the weather is getting colder in many parts of the country, staying active is a crucial component in the treatment and prevention of cancer. Regular exercise may translate into a 20 to 30 percent lower risk of developing breast cancer. Even making time for a 20-minute walk each day can help reduce the risk of breast cancer – while also diffusing pandemic-related stress.
Exercise can also play an important role for those newly diagnosed with breast cancer. “More and more data are showing the increasing importance of exercise after a cancer diagnosis,” said Jessica Scott, PhD, an exercise physiology researcher on MSK’s Exercise Oncology Service. “Our research is ongoing but we already know that a relatively small increase in vigorous exercise can have a significant benefit for cancer survivors and those actively in treatment.”
Understand your genetic risk
When it comes to breast cancer prevention, knowledge is one of the most powerful tools available. In addition to knowing whether your family has a history of breast cancer, it may also be important to discuss with your doctor a blood test to understand whether you may be at greater risk of contraction due to genetics. While it can be daunting to find out you’re at a higher risk, that knowledge will allow you to take more preventive measures and ultimately improve your chances of avoiding breast cancer.
MSK’s Risk Assessment, Imaging, Surveillance, and Education (RISE) Program was developed to help women take a proactive approach to their risk factors. “We now know that standardized risk assessment and surveillance for breast cancer is not one-size-fits-all,” explained Melissa Pilewskie, MD, a surgeon and a Director of MSK’s RISE Program. “The same way we tailor breast cancer treatment, we need to tailor surveillance and prevention programs based on a woman’s specific risk profile.”
Maintain healthy habits
The stress of the past seven months has affected us in countless ways, and it’s understandable that some women may feel inclined to adopt – or fall back into – bad habits like smoking, drinking to excess, or eating an unhealthy diet. That said, these activities are as unhealthy as ever, and can compound women’s risk of contracting breast cancer. In fact, a recent study found that a third of breast cancer cases possibly have roots in issues such as obesity, alcohol use, and inactivity.
When it comes to reducing the risk of breast cancer – and living a healthy life in general – there’s little room for a consistently unhealthy lifestyle. “People may not realize just how much obesity affects their risk of cancer. We need to start thinking of some foods in a similar way that we think about tobacco: unnecessary, addictive, and harmful,” said Neil Iyengar, MD, a medical oncologist at MSK. “It’s really important that public health messages specifically drive home the connection between obesity and cancer.”
“In the past 10 years in the U.S., despite a stable rate of diagnoses, the death rate from breast cancer has dropped an average of 1.9 percent per year. This is due to a combination of improved diagnosis through screening and advances in treatment. But we know that we can do even better if we increase screening rates and if more people exercise, eat well, and live healthy lives,” Dr. Norton said. “We established Breast Cancer Awareness Month to make people aware that they had the power to conquer this disease. That progress is steady and considerable, but we must not let this pandemic ruin our momentum.”
