Breast Cancer in Hawai‘i

“What
if they find something? I don’t know if I could deal with that!” remarks Priscilla
Batul, an ‘Ewa Beach resident, when asked what she fears most about having her
yearly mammogram. As a clinic aide in a doctor’s office, she knows how important
it is to stay healthy, and recalls that her first test wasn’t that bad. “It was
uncomfortable, but not really painful.” However, she readily admits that her biggest
fear is hearing there’s something wrong. “Even though I see a lot of women who
have had breast cancer and look healthy, it’s still hard to think that it could
be you.” And Batul is right to be concerned: More than 200,000 women will be diagnosed
with breast cancer in the United States this year, and more than 40,000 women
lose their lives annually to this disease.

Hawai’i ranks 43rd in the nation
in the number of women between the ages of 40 and 64 who have their yearly mammograms.
Recent studies have shown that Filipinos and Native Hawaiians have the lowest
rates of mammograms in the state. This may explain why Hawaiians have the third-highest
breast cancer mortality rate in the nation. Mammography done every year or two
in a woman over the age of 50 may reduce her risk of dying from breast cancer
by 30 percent. So why aren’t women getting mammograms?

According
to Dr. Ratheany Sakbun, of North Hawai’i Community Hospital, the most common reason
is fear-and wishful thinking. Many women are afraid that the test is going to
hurt, or afraid of finding out that they have cancer, or think that cancer won’t
happen to them. However, Sakbun points out, “Most women with breast cancer have
no family history of the disease, and aren’t aware of their risk factors or how
important this test is.”

It’s particularly important to catch breast cancer
in its early stages. Breast cancer survivor Geraldine Yamashita encourages her
friends to get checked. “Mammography saved my life. My cancer was found in the
earliest stages, and, after chemotherapy and radiation, I’m doing fine.” She has
seen many others whose cancers were far advanced by the time they were diagnosed,
who did not survive.

The American Cancer Society recommends that women
have yearly breast exams done by a doctor, and yearly mammograms after age 40.
Women should review their exam techniques with their doctors, and then do their
own self-exams every month. The best time to do a self-exam is a week after the
menstrual cycle, or if in menopause, at the same time every month. (This is also
the time to do a mammogram.) If possible, it’s best to have mammography done at
the same center every year, so that subtle changes in breast tissue can be monitored.

Mammograms are offered at most major medical centers, in addition to women’s
health centers across the country. In addition to the X-rays, many centers are
now offering digital mammography, with computer readings, and specialized radiologists
reviewing the films. Health insurers, such as HMSA, are starting to cover this
additional service. The accuracy of a mammogram increases with both the computer
reading and the doctor’s reading, and it becomes possible to diagnose cancers
in their earliest stages. Newer techniques, such as breast MRI, are now being
researched across the nation. For high-risk women, this test may be better than
a standard mammogram, and, in some cases, can be as accurate as a biopsy.

October
is National Breast Cancer Awareness month. All women are encouraged to ask their
doctors when they had their last mammograms, and to schedule their next one whenever
it’s due. “Although scary, finding out that everything is OK is the best peace
of mind a woman can have,” says Batul.