|Attendees at ORWH’s breast cancer seminar included (from l) Dr. Ngina Lythcott, Black Women’s Health Imperative; Dr. Rowan Chlebowski, UCLA Medical Center; and Dr. Robert Smith, American Cancer Society.
In celebration of National Women’s Health Week, the Office of Research on Women’s Health hosted a seminar titled “A Focus on Breast Cancer” on May 11 at Lipsett Amphitheater. The seminar featured three national experts who discussed topics ranging from breast cancer screening and incidence to representation
of minorities in breast cancer research.
Dr. Rowan Chlebowski of UCLA Medical Center shared findings suggesting that the incidence of breast cancer has decreased substantially since results from hormone therapy trials were released in 2002. Conducted under the Women’s Health Initiative, these trials showed that postmenopausal women receiving estrogen plus progestin were at increased risk for invasive breast cancers. In the year following this startling research, there was a 58 percent
decline in prescriptions for menopausal hormone therapy. And in 2006, there were 20,000 fewer invasive breast cancers than in 2002. “Discontinuation
of hormone therapy,” said Chlebowski, “likely represents a therapeutic effect of estrogen decrease on already present preclinical breast cancers.”
Dr. Robert Smith of the American Cancer Society identified current challenges
in breast cancer screening in the United States. While the quality of screening has improved measurably since the Mammography Accreditation
Program was established in the late 1980s, many hurdles remain. These include improving the accuracy of mammography interpretation, imaging dense breasts, identifying women at high risk and communicating the limitations
and potential risks of mammography.
Citing research studies from Sweden and Canada, Smith emphasized that, despite challenges in breast cancer screening, “The efficacy of mammography is well established in women ages 40 to 69. Randomized trials provide convincing
evidence that an invitation to screening is associated with a reduced risk of dying from breast cancer.”
Dr. Ngina Lythcott of the Black Women’s Health Imperative, proposed that the November 2009 U.S. preventive services task force (USPSTF) report on mammography relied on research that was not representative of the diversity
of the U.S. population. “Large, systematic reviews that neglect to include parts of the population can lead to outcomes that can be wrong—even dangerous—
for those populations,” said Lythcott.
The 2009 report recommended mammography for women every other year beginning at age 50, rather than annually beginning at age 40. But Lythcott, a 21-year breast cancer survivor, pointed out that black women are generally
diagnosed with breast cancer at a younger age and the disease is generally
more virulent among blacks. “At the moment, mammograms are the best detection tool we have,” she said. “The earlier the diagnosis and treatment, the better the cancer survival rates.” She emphasized that the USPSTF findings
should not be used to limit access to mammograms for younger women at increased risk.