Supervisors push early detection in fight against breast cancer

SAN JOSE – The Santa Clara County Board of Supervisors this week directed County officials to expand opportunities for breast cancer screening for County residents to ensure early detection of breast cancer.

County Supervisor Joe Simitian, who authored the proposal with Supervisor Sylvia Arenas, said he hoped to see “more screenings, in more places, serving more people,” given the importance of early detection in the fight against breast cancer. Simitian specifically called out the need for additional, alternative screening technologies particularly for women with dense breast tissue. 

As part of the proposal from Simitian and Arenas, the Board directed staff to provide information about cost, logistics, and the potential efficacy of improving or expanding current programs. County staff was also tasked with providing ideas for potentially new programs and public outreach. 

“We know that early detection is crucial for effective treatment,” said Simitian. As a member of the California State Senate, Simitian 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. Dense breast tissue – present in nearly half of women over 40 – makes abnormalities like cancer more difficult to see on a mammogram, and also indicates a woman’s increased risk of breast cancer.

According to the American Cancer Society (ACS), breast cancer is a leading form of cancer in women, accounting for 30% of new cancers each year and the second-leading cause of cancer deaths. Black women are 40% more likely to die from breast cancer than white women and have the lowest five-year relative breast cancer survival rate of any racial or ethnic group. For Hispanic women, breast cancer is the leading cause of cancer death. In all, about 42,000 women and 500 men in the U.S. die each year from breast cancer.

“We know that regular mammogram screenings are the best way to detect these types of cancers early, and that some women may want to discuss alternative screenings with their doctors,” said Simitian, who is Chair of the County’s Health and Hospital Committee.

“Early detection of breast cancer is critical, and we know this is especially true for women of color,” said Arenas. “When breast cancer is detected and treated early, the five-year survival rate is 99%. With this in mind, our policy request calls for identifying the barriers to access for breast cancer diagnostic screenings and creating equitable solutions that can address racial and health disparities in our community – steps that can and will save women’s lives.”

“As an organization that helps cancer patients and their families for free, we see women diagnosed with breast cancer and the challenges that come with a cancer diagnosis.  These challenges increase exponentially if the diagnosis is late stage,” said Dawn Hogh, Executive Director of Cancer CAREpoint. “The earlier breast cancer can be detected, the better the outcome for the patient and their loved ones.”

Unfortunately, diagnostic imaging and alternative screening options currently are not accessible to many individuals. Mammograms, for example, typically must be conducted at imaging centers or hospitals, and they are then interpreted by radiologists. In addition to the high costs placing mammograms beyond the reach of individuals without (or with insufficient) insurance, knowing where and how to schedule a mammogram isn’t always clear, especially if the patients do not have a regular primary care provider.

In 2021, the County created a first-of-its-kind program to expand access to lifesaving medications through MedAssist. MedAssist helps County residents offset the costs of medications to treat diabetes, asthma inhalers, and epinephrine auto-injectors (Epi-Pens). Through a combination of coordinating County resources and outreach programs, the County has assisted thousands of residents for whom these medications would otherwise be out of reach.

“A similar program for mammograms and alternative screening options would have tangible benefits for our residents,” said Simitian. “By increasing the rate of early detection, patients can maximize their chances to seek early treatment and, in turn, achieve eventual remission. Early treatment can also help folks preserve their quality of life, which might otherwise be compromised by the more invasive and extensive treatments required for more advanced cancers, and reduce the heavy financial burdens that often accompany such treatments. And needless to say, early intervention is by far less expensive than treating late-stage cancer.”

“Community Health Partnership and its members applaud the Board of Supervisors for seeking options to improve access to mammograms and alternative screening options that are a necessary healthcare service,” said Dolores Alvarado, CEO of Community Health Partnership. “We support a comprehensive approach to cancer detection and early diagnosis that encompasses outreach and education, linkages to a medical home and primary care provider, access to enrollment services and new or enhanced programs to serve all County residents.”

Both the County and State of California already have programs in place that help residents cover the costs of mammograms. Simitian and Arenas’ proposal directs County staff to provide:

• An estimate of the costs, logistics, and potential efficacy in improving/expanding existing programs, to maximize access to mammograms and related diagnostic imaging for the early detection of breast cancer.

• An analysis of the opportunity and/or need to create new programs, specifically for this purpose.

• Outreach plans for communicating the availability of this expanded access to those who need it most, and for ensuring that procedures are in place to overcome bureaucratic hurdles that might currently exist.

The Simitian/Arenas proposal was supported by Cancer CAREpoint, Are You Dense, Inc. and Are You Dense Advocacy, Inc., Community Health Partnership, Asians Americans for Community Involvement, Latinas Contra Cancer, and Bay Area Cancer Connections.