Breast Cancer Awareness Month

October is Breast Cancer Awareness Month. Breast cancer is a cancer that develops from breast tissue. It is one of the most common types of cancer in women, but it can also affect men. Breast cancer is the second leading cancer among women, slightly behind skin cancer.

Breast cancer is also the main cause of death in women ages 39 -45, and roughly 1 in 7 women will develop breast cancer in their life span. According to the American Indian Cancer Foundation, 1 in 8 American Indian women will get breast cancer in their lifetime. Nationally, the rates for breast cancer among American Indian/Alaska Native females from 2014 to 2019 were 110.5 per 100,000 compared to 126.9 per 100,000 for all races combined.

In the United States, about 310,720 new cases of invasive breast cancer will be diagnosed in women in 2024. Over 55,000 new invasive cases and over 8,000 non-invasive cases are diagnosed annually. 80% of new breast cancer diagnoses are in women over 50 years of age. Around one man a day is diagnosed with breast cancer. Breast cancer was the most common cancer in women in 157 countries out of 185 in 2023 and caused 670,000 deaths globally.  Despite national decreases in breast cancer incidence and mortality rates, declines in these measures have not yet appeared among American Indian/Alaska Native women. Health disparities in breast cancer persist, resulting in higher stage at diagnosis, and lower screening rates compared to other racial and ethnic groups. Disproportionately more AI/AN are younger at diagnosis. Screening beginning at age 40, improving access, annual rescreening, community education and outreach, and mobile mammography for rural areas are ways to improve these disparities.

Roughly half of all breast cancers occur in women with no specific risk factors other than sex and age. The main risk factors include being female, having a family history of breast cancer, previously having breast cancer, long-term hormone therapy (through birth control or hormone replacement during menopause), and obesity. Having children later in life, or not at all, also increases the risks. So basically, almost every woman is at risk, and some just for simply be alive.

Regular breast examinations/mammograms are recommended for early detection and treatment, along with self-exams. Here are the main symptoms to look for:

• A lump or mass in the breast that feels different from the surrounding tissue
• Change in the shape, size, or appearance of the breast
• Discharge from the nipple
• Breast rash
• Breast pain
• Inverted or pulling-in of the nipple
• Scaling, peeling, or flaking skin over the breast, particularly the dark area around the nipple
• Redness and/or pitting of the breast skin, resembling the skin of orange

Performing a self-examination can feel awkward at first, but the more you do it the more comfortable you'll be. My first time doing one I thought I felt a hard lump. It turns out it was a rib, but my doctor was pleased that I took it seriously. You'll be searching for a mass of tissue that can either feel hard or lumpy/squishy. My doctor told me to feel for something the size and texture of a discarded piece of chewing gum. Not all masses will feel like that, it's just a good point of reference.

My dear friend Hauli Sioux Gray (Ponca and Tonkawa) was recently diagnosed with breast cancer for a second time. 5 years ago, after undergoing chemotherapy and surgery to remove her left breast, her doctor prescribed proton therapy with hopes it would reduce the risk of heart problems in the future from excess radiation. Her insurance company, Blue Cross Blue Shield of Oklahoma, didn't think the more expensive form of radiation was necessary, and denied her claim THREE times!

She started proton therapy at ProCure, an Oklahoma City radiation facility without knowing if anyone would cover it. Hauli's Indian Health Services agreed to pay for her care before she completed it that year. Though her therapy was covered, she wanted to speak for other patients who may not have the same options. "My request is, that in the future, insurance companies rely on the patient’s physician to recommend the best treatment – those that not only save the patient’s life, but also provide the best quality of life after cancer, no matter the cost." - Hauli

Hauli has now been diagnosed with breast cancer again and her treatments have started. She is one of the strongest and most inspirational women I have ever known. Through all of her pain, discomfort, and treatments, nothing has stopped her from showing up for her family and advocating for herself and others. And through it all, she's appeared in the acclaimed film "Fancy Dance" and modeled in some of Indian Country's premier fashion shows.

Women, especially Native women, must advocate for ourselves when it comes to medical issues. Time and time again our concerns are dismissed by doctors and we're diagnosed with anxiety, acid reflux, and/or depression, when most of the time something more serious, even life-threatening, is at play.