Pushing for early detection in the fight against breast cancer

As Chair of our County’s Health and Hospital Committee and author of state legislation focused on early detection, I well know that breast cancer is a formidable adversary. 

Breast cancer accounts for 30% of new cancers each year, causing the deaths of about 42,000 women and 500 men in the U.S annually, according to the American Cancer Society. Women of color are particularly hard hit: breast cancer is the leading cause of cancer death for Hispanic women, while Black women are 40% more likely to die from breast cancer than white women. 

However, we are not without weapons — or hope. Regular mammogram screenings are the best way to detect these types of cancers. Early detection means more effective, less invasive treatment. When breast cancer is detected and treated early, the five-year survival rate is 99%.

Simply put, to save lives in the fight against breast cancer, we need more screenings, in more places, serving more people. 

I’m gratified that my colleagues on the Board of Supervisors agree, approving my recent proposal to expand opportunities for County residents to access screenings that ensure early detection of breast cancer.

Of particular importance is increasing access to additional, alternative screening technologies for women with dense breast tissue — present in nearly half of women over age 40 — which makes breast cancer more difficult to spot on a mammogram, and also indicates a woman’s increased risk of breast cancer.

My proposal directed County staff identify the barriers to access for breast cancer diagnostic screenings, expand availability of screenings, and develop solutions that address the racial and health disparities in our community.

Breast health has long been a policy priority for me. As a member of the California State Senate, in 2012 I authored Senate Bill 1538, which required that, following a mammogram, women are notified if they have dense breast tissue, and of the range of screening options available to them. (The U.S. Food and Drug Administration is at last catching up, with nationwide mammography standards similar to California’s going into effect in September.)

The challenges that come with a cancer diagnosis increase exponentially if the diagnosis is late stage. More advanced cancers require more invasive and extensive treatments, and often have heavier financial burdens.

By increasing the rate of early detection, patients can maximize their chances for early treatment and, in turn, achieve eventual remission. 

Unfortunately, diagnostic imaging and alternative screening options currently are not accessible to far too many individuals. 

Mammograms, for example, typically must be conducted at imaging centers or hospitals, and they are then interpreted by radiologists. While both the County and state of California have programs in place that help residents cover the costs of mammograms, fees can still be beyond the reach of individuals without (or with insufficient) insurance. In addition, knowing where and how to schedule a mammogram isn’t always clear, especially if the patients do not have a regular primary care provider. 

Alternative options to mammography are even more elusive. Digital breast tomosynthesis, for example, is gaining in popularity, but isn’t yet widely available. Further, patients might not be aware that MRI or ultrasound screening is a better option for them depending on their breast density and cancer risk. 

What we need is a comprehensive approach to cancer detection and early diagnosis – one that optimizes access to mammograms and the alternative screening options that are a necessary health care service.

I’m pushing our County to that path, with a proposal calling for an estimate of the costs, logistics, and potential efficacy in improving and expanding existing screening services — through outreach and education, easy-to-access enrollment, and new or enhanced programs and technologies to serve all County residents.

The earlier breast cancer can be detected, the better the outcome for the patient and their loved ones. That’s worth a fight.

This article was originally published in Los Gatos Living in February 2024.