“The incidence of breast cancer is going up, so the number of women being diagnosed with breast cancer per year is rising,” said Dr. Rebecca Tuttle, a surgical oncologist at Kettering Health.
Heading into Breast Cancer Awareness Month, local health providers say it’s important to get regular screenings for breast cancer in order to catch it early when the cancer is easier to treat. The Dayton Daily News talked to two local breast cancer survivors who each caught their cancers through regular screening, and while fighting cancer is a difficult ordeal, they encouraged women to stay on top of their mammograms.
“If you catch breast cancer early, it is 99% curable, so the screening is very important for that early diagnosis,” said Tracy Short, director of Premier Health’s ambulatory imaging center.
In Ohio, breast cancer was the highest of all new invasive cancer cases in 2020, accounting for 14.6% of new invasive cancer cases, according to the Ohio Department of Health’s 2023 annual cancer report. Cancers of the lung and bronchus followed, accounting for 14.2% of new cancers in Ohio in 2020.
The incidence rate for female breast cancer in Ohio in 2020 was 122.8 cases per 100,000 women.
Local survivors share impact of screenings
As a nurse with Premier Health, Caroline Mombay was used to being by the bedside instead of in the patient’s seat, being faced with a difficult decision. So it was a different feeling for Mombay to learn she had breast cancer late last year.
“It didn’t stop me from thinking what to do next, like I have to move forward from this,” said Mombay, who lives in Tipp City.
Mombay had undergone her annual mammogram, which led to additional imaging and a biopsy after doctors discovered she had a high-risk lesion called atypical ductal hyperplasia. After her biopsy last November, she found she had a non-invasive cancer called ductal carcinoma, meaning it could not spread outside of the breast at that stage.
The danger with those cells, though, is that they can continue to undergo abnormal changes that cause it to become invasive breast cancer, which can spread, according to the American Cancer Society. Doctors recommended Mombay have the cancer surgically removed. Mombay decided to go a step further and proceed with a mastectomy without reconstruction.
“They laid down a lot of treatment options, and in the end, I decided to do the aggressive route, which is the mastectomy,” Mombay said. A mastectomy is the surgical removal of a breast, compared to a lumpectomy, which is when the surgeon removes the cancer or other abnormal tissue and a small amount of the healthy tissue that surrounds it, according to the Mayo Clinic.
Choosing to undergo a mastectomy is a personal choice for patients, Mombay said.
“It’s a big, big hard decision. I thought of it several times, but I didn’t want to go back to the operating room in 10 years or in five years time, so that was aggressive on my part,” Mombay said.
For Judy Ippisch, her breast cancer diagnosis in January 2019 hit her like a brick.
There’s not a day that passes where she forgets her experience, said Ippisch, who lives in Oakwood and is a nurse for Kettering Health. “I went through six months of chemotherapy, and then I had surgery.”
Ippisch had triple-negative breast cancer, which is the most aggressive form of breast cancer. The triple-negative refers to the cancer cells lacking estrogen or progesterone receptors, and the cancer cells also don’t contain much or any of a protein called HER2, according to the American Cancer Society, which makes the cancer more difficult to treat.
“It was caught through regular screening,” said Ippisch, who encouraged women to stay on top of their health.
Possible factors to increased rates
With cancer rates going up, there are a number of possible factors that have yet to be confirmed, though doctors suggest COVID disrupted people seeking regular cancer screenings, potentially putting off catching cancers until they are were at more developed stages.
Breast cancer incidence rates in Ohio increased from 2011 (125.4 cases per 100,000 women) to 2019 (132.2 cases per 100,000 women) but decreased in 2020 (122.8 cases per 100,000 women), according to ODH. Cases were likely lower in 2020 due to disruptions in access to care, including delays in cancer diagnoses and screenings, during the COVID-19 pandemic, ODH said.
Female Breast Cancer Incidence Rates by County, Ohio, 2016-2020, according to ODH
|County||Rate per 100,000 women|
“There was some issues with COVID, like delays with patients getting their mammograms. Somebody who would have gotten their mammogram at 40 probably didn’t because of COVID and waited until 42 so then they might have missed an early breast cancer in that patient,” said Dr. Neha Sarvepalli, a surgical oncologist with Premier Health.
Doctors are also better at catching cancers, particularly with having both three-dimensional and two-dimensional imaging available to them.
In addition to technology improving, health providers are paying more attention to women with dense breast tissue, which makes them more prone to having cancer due to the difficulty of detecting cancers just through mammograms.
“Now it is the law that you have to notify a woman of her breast density with her mammogram and try to then identify additional screening tests for women with dense breasts to try to better detect their breast cancers,” Tuttle said. “Increased breast density increases your risk of breast cancer and also can make it harder to find a breast cancer in your breast.”
Women with dense breast tissue can go through additional testing with different technology, like ultrasounds or MRIs.
Impacts from environment
Researchers are also looking at environmental factors that could be impacting cancer rates, such as air pollution or forever chemicals like per- and polyfluoroalkyl substances (PFAS). PFAS are chemicals that resist grease, oil, water, and heat, according to the U.S. Centers for Disease Control.
“All cancer rates are going up,” Ippisch said. “It just makes you wonder…what is in our environment? What’s making our cells work so differently?”
Researchers at the National Institutes of Health recently published a new study in the Journal of the National Cancer Institute that found living within an area with higher particulate air pollution was associated with an increased incidence of breast cancer.
The largest increases in breast cancer incidence was among women who on average had higher particulate matter levels (PM2.5) near their home prior to enrolling in the study, researchers said. Particulate matter refers to a mixture of solid particles and liquid droplets found in the air, which can come from things like exhaust, combustion processes, wood smoke, vegetation burning, or industrial emissions, the researchers said.
“We observed an 8% increase in breast cancer incidence for living in areas with higher PM 2.5 exposure. Although this is a relatively modest increase, these findings are significant given that air pollution is a ubiquitous exposure that impacts almost everyone,” Alexandra White, lead author and head of the Environment and Cancer Epidemiology Group at NIEHS, said in a news release. “These findings add to a growing body of literature suggesting that air pollution is related to breast cancer.”
In regard to PFAS, researchers found there were increased odds of previous melanoma diagnoses in women across exposure to multiple categories (phenols, parabens, and per- and polyfluoroalkyl substances), and increased odds of previous ovarian cancer was associated with several toxins and compounds known as phenols and parabens. The study was published in the Journal of Exposure Science & Environmental Epidemiology.
The best thing women can do is keep up with annual mammograms, doctors say.
“For all women, I think you should have at least one good clinical breast exam a year. And after the age of 40, we recommend mammograms every year until your life expectancy is less than 10 years,” said Sarvepalli. “Even if you’re 80 and you’re healthy and you’re walking around and you’re taking care of yourself, get that mammogram because the idea is you want to catch it early.”
Approximately 1% of breast cancers are also found in men. While men do not need to undergo regular screening, they should consult a doctor if they come across any symptoms in the breast, such as lumps, redness, irritation, or discharge.
Schedule a mammogram
Schedule a mobile mammogram with Premier Health by calling 855-887-7364. For more information about the process and locations, visit www.premierhealth.com/mobilemammo or email MobileMammo@premierhealth.com.
For Kettering Health, call call -937-299-0099 or visit its website at ketteringhealth.org/pink.
For Mercy Health, visit https://www.mercy.com/ to find a provider. Springfield-region patients can also call 937-523-9699 and Cincinnati-region patients can call 513-981-2222 to set up appointments.
By the numbers
Breast cancer was the leading cause of cancer incidence in Ohio in 2020, representing 14.6% of all new invasive cancer cases, followed by lung and bronchus cancer (14.2%), prostate cancer (12.8%), and colon and rectum cancer (7.9%), according to the Ohio Department of Health.
In 2020, there were 9,516 new cases of breast cancer, including 77 in men, in Ohio. There were 1,671 deaths attributed to breast cancer in 2020, including 23 men.
In 2020, cancer remained the second most common cause of death in Ohio and the U.S., accounting for nearly one of every four deaths. Cancer was the cause of death for 24,858 Ohioans in 2020. Ohio’s age-adjusted cancer mortality rate (158.5 per 100,000) was 10% higher than the U.S. rate (143.8 per 100,000).
Lung and bronchus cancer was the leading cause of cancer death in Ohio in 2020, representing 25.1% of all cancer deaths, followed by colon and rectum cancer (8.5%), pancreatic cancer (7.5%), and breast cancer (6.7%).