Susan G. Komen Central and Northern Arizona Frank Nagy, Mission Director WHY IS EARLY DETECTION IMPORTANT? WHY IS EARLY DETECTION IMPORTANT? Regular screening tests (along with follow-up tests and treatment if diagnosed) reduce your chance of dying from breast cancer. After all, screening tests can find breast cancer early, when the chances of survival are highest. 1
WHY IS EARLY DETECTION IMPORTANT? Greatly increases the chances for successful treatment Often less costly to treat when caught at early stage Treatment less invasive and shorter duration, less opportunity for adverse effects, complications STAGE 5-year Relative Survival Rate 0 100% I 100% II 93% American Cancer Society Last Medical Review: 09/25/2014 III 72% IV 22% Last Revised: 02/26/2015 EARLY DETECTION SAVES LIVES Early detection and effective treatment have resulted in a decline in breast cancer mortality in the U.S. 34 percent since 1990! There are more than 3.1 million breast cancer survivors in the U.S. today. HOW DO WE SUPPORT AND PROMOTE EARLY DETECTION? 2
HOW DO WE SUPPORT AND PROMOTE EARLY DETECTION? Patient Education Provider Education HOW DO WE SUPPORT AND PROMOTE EARLY DETECTION? Become educated and familiar with Breast Self Awareness (BSA) messaging Be clear and understand the breast cancer screening guidelines BREAST SELF AWARENESS MESSAGING 3
HOW DO WE SUPPORT AND PROMOTE EARLY DETECTION? BREAST SELF AWARENESS: 1.Know your risk 2.Get screened 3.Know what is normal for you 4.Make healthy lifestyle choices Breast Self Awareness Messaging KNOW YOUR RISK: The most common risk factors are being female and getting older. There are known risk factors that you can control and others you cannot change. Talk to both sides of your family about your family health history Talk to your doctor about your personal risk of breast cancer Breast Self Awareness Messaging GET SCREENED: Talk with your doctor about which screening tests are right for you if you are at higher risk Have a mammogram every year starting at age 40 if you are at average risk Have a clinical breast exam at least every 3 years starting at age 20, and every year starting at age 40 4
Breast Self Awareness Messaging KNOW WHATS RIGHT FOR YOU: Know how your breasts look and feel and report any changes to your health care provider Breast Self Awareness Messaging MAKE HEALTHY LIFESTYLE CHOICES: Maintain a healthy weight Add exercise into your routine Limit alcohol intake Limit the use of menopausal hormones Breastfeed, if you can BREAST CANCER MAMMOGRAPHY SCREENING GUIDLINES 5
Mammography Screening Guidelines Susan G. Komen Supports Annual screening mammograms for women 40 yrs. or older of average risk. American Cancer Society Supports Annual screening mammograms for women 40 yrs. or older of average risk United States Preventative Services Task Force (USPSTF) Supports Biannual screening mammograms for women beginning 50 years or older. Mammography Screening Guidelines Komen s concern with USPSTF guidelines recommendations 1) FINANCIAL ISSUES 2) VIGILANCE 3) IMPACT ON MINORITY/DISPARATE POPULATIONS 4) ONE-SIZE-DOES-NOT-FIT-ALL Mammography Screening Guidelines 1) FINANCIAL ISSUES: USPSTF recommendations are often used by insurance companies and government programs to determine payment for screening tests, we remain concerned that these tests will not be paid for. This creates a potential economic barrier for women who, with their healthcare providers, want or need screenings at an earlier age. 6
Mammography Screening Guidelines 2) VIGILANCE: Women and their health care providers may view an age 50 guideline as an indicator that they don t need to worry about breast cancer risk until age 50. Women should be aware of their risk and talking about it with their health care providers at much earlier ages. And health care providers should have complete information about breast cancer risk so that they can make screening recommendations appropriate for their individual patients. Mammography Screening Guidelines 3) IMPACT ON MINORITY/DISPARATE POPULATIONS: The impact of delaying screenings would be especially troublesome for minority women and younger women who are often diagnosed with more aggressive forms of breast cancer before age 50. African American women, for example, are diagnosed with breast cancer at earlier ages on average than white women and are more likely to be diagnosed with Triple Negative Breast Cancer, an aggressive form of the disease. The benefits of early detection and effective treatment are well established: our goal is to detect breast cancer at its earliest stages, when there are more options for treatment. i. This is one reason Komen continues to advocate for expansion of the National Breast and Cervical Cancer Early Detection Program which provides screenings for low-income women. Mammography Screening Guidelines 4) ONE-SIZE-DOES-NOT-FIT-ALL Just as breast cancer treatment has evolved from the one-size-fits-all approach of past years to more personalized and targeted therapies, breast cancer screening is evolving as well. Today, we have a greater understanding of risk factors such as genetic mutations, family history and exposure to radiation at a young age. It is becoming increasingly apparent that screening recommendations relying on age alone should not be the only standard. Any recommendations must take into account an assessment of an individual s risk for breast cancer. 7
WHAT DOES ALL THIS MEAN If we can catch cancer at its early stage when it is most treatable we improve health outcomes and reduce costs. How do we catch cancer breast cancer early? By promoting both Breast Self Awareness (BSA) and recommending appropriate screening at appropriate age. Is this just the responsibility of the patient or provider? NO! Patients need to know what looks right feels right as well as ask for appropriate screenings. Providers (gate keepers for screenings) need to be sure those who should be screened are being screened. Understand and know the breast cancer screening guidelines. Encourage patients to be breast self aware and report any changes or concerns. KOMEN FUNDED CHANGE PACKAGE TOOLKIT 8
Change Package Toolkit What is it? This Change Package shares recommended interventions and successful strategies that have been tested and documented, and can be used by clinics certified as patient-centered medical homes or in the process of adopting those standards. The package includes step-by-step instructions, examples,and resources to implement breast health process improvement programs for rapid innovation at your primary care clinic. While focused on breast health screening improvement, we encourage you to use these practices with any patient population and preventive screening protocol. HOW CAN THE CHANGE PACKAGE TOOLKIT BE HELPFUL? 1. Define the Population 2. Access to Screening Appointments and Building Capacity 3. Determine a Data Collection Plan to Measure Progress 4. Patient Navigation at the Clinic Level 5. One-to-One Relationship between Clinic and Screening Facility 6. Process Improvement Meetings with the Clinic Project Team CONTACT INFORMATION Frank Nagy 602-544-2873 fnagy@komencanaz.org 9
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