DeSantis Breast Cancer Diagnosis Raises New Awareness

Miami FL

07 October, 2021

8:53 AM

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By Johania Charles, the Miami Times Oct 5, 2021 On Monday, Florida Governor Ron DeSantis delivered the news in a statement, not specifying the type or stage of the cancer, or whether his 41-year-old wife is currently receiving treatment. "Casey is the centerpiece of our family and has made an impact on the lives of countless Floridians through her initiatives as first lady," he said in a statement. "As she faces the most difficult test of her life, she will have not only have my unwavering support but the support of our entire family...Casey is a true fighter, and she will never, never, never give up." The mother of three and former Jacksonville TV personality is known for advocating for mental health issues and substance abuse services while working on her husband's administration. "All of Florida is rooting for you," read a tweet from Miami Sen. Annette Taddeo directed towards the first lady. While local elected officials are wishing Casey a speedy recovery, health professionals are encouraging younger women to not wait on the state's age requirement for mammograms before starting self-exams or speaking out about their breast health. The National Breast Cancer Foundation reveals that one in eight American women will develop breast cancer, with it being the most common form of cancer among women worldwide. Starting at age 50, women are required to get mammograms yearly. Florida statutes state that women who are 40 and older, can get a mammogram every two years. Women most commonly diagnosed with breast cancer are between 55 - 64 of age, according to the National Cancer Institute. Statistics reveal that certain racial and ethnic groups are disproportionately impacted by breast cancer. "There are women who may fall into the higher risk category. Women who are of other ethnicities such as [Black] or Hispanic women, may be at higher risk of developing breast cancer at an earlier age," said Dr. Starr Mautner, a breast surgeon at Baptist Health System's Miami Cancer Institute. "So the recommendation is really starting at age 30, not necessarily getting a mammogram, but knowing your risks." The risks, Mautner says, can be evaluated using breast cancer risk assessment tools easily accessible online. The risk calculator assesses family history, genetic mutation and other factors that influence the likelihood of developing breast cancer. According to Mautner, Baptist's cancer institute has seen an increase in breast cancer patients below the common age range. "It seems that on a weekly basis, I'm seeing a patient under the age of 40 diagnosed with breast cancer and so I feel like there has been an uptick," said Mautner, revealing that some of her senior colleagues have also attested to that. Typically, 90% of the institute's breast cancer patients are women older than 40 and about 10% are those under 40. "There are women that may fall into the higher risk category that may want to start at age 35 but that's a very personalized decision and not one for everyone," she added. Miami's Cancer Institute, however, provides mammogram screening for women without significant risk factors starting at 40, and can supplement the screening with a breast ultrasound for dense breast tissue. "A lot of risk factors are genetic, but the part that is the environment are the things we can control for," added Mautner. Key ways women can try to prevent breast cancer is by abstaining from alcohol and limiting consumption to once a week at most, eating a well-balanced diet, an exercise regimen of at least 30 minutes a day, and self-examination. Because treatment depends on the type of breast cancer and stage, some patients may require a surgical removal of the cancer while others can benefit from oral medication, radiation, chemotherapy. Sometimes treatment can require a multimodality approach. Stage 0 - 1 breast cancer has a 95% - 99% overall survival rate. At stage 2, the survival rate is at 85% and decreases with each subsequent stage. "When we talk about prognosis, how well patients will do or the risk of recurrence, we rely on the staging," said Mautner. "It's all based on how early the cancer is caught, which is why early detection saves lives. Mammograms save lives.In an ideal circumstance, you want to catch the cancer before you can ever feel it." Dr. Judith Hurley, a Jackson Health System oncologist with a specialty in breast cancer. (Courtesy of Judith Harley) Dr. Judith Hurley, University of Miami professor and a Jackson Health System oncologist with three decades of experience specializing in breast cancer, says her department hasn't seen a significant increase in the number of younger women diagnosed with breast cancer. "I don't think there's been an increase, there's just an increased awareness of breast cancer," she said. "Historically, Black women have been diagnosed with breast cancer less but had a higher mortality rate. We've seen that their diagnosis has steadily increased so that it now equals the rate at which white women are diagnosed and continue to have a high mortality rate." She says improvements made over the years in breast cancer treatment across the country, including the use of adjuvant chemotherapy after surgery, have tremendously helped in preventing relapse and decreasing the mortality rate among patients. Last Thursday, the Carrie's Touch support services organization funded by the California Breast Cancer Research Program, released data from a research project conducted with UCLA that puts the mortality rate at 41%. In evaluating the disparities, the assumption for why ethnic groups had a different outcome was because of health care access but Hurley affirms that access is not the main cause. According to her, Black women are more likely to be diagnosed with metastatic triple-negative, the more aggressive type of breast cancer, likely due to genetics and environmental factors. "People with inherited genetic mutation, which can come from both sides of the family, have an 80% chance of developing breast cancer," said Hurley, who has a 30-year-old Black cancer patient. "You have to evaluate your risk to decide how you're going to deal with the risk. The average breast cancer patient is a white 62-year-old woman [but] Black women develop breast cancer about five years earlier." In a health disparities research Hurley conducted with a team last year, focusing on the Caribbean, gathered data reveal that the highest rate of inherited breast cancer is found in the Bahamas, though Caribbean women have had better survival rates than Black American women. "You don't have to stick to the [mammogram] guideline if there's something going on with your breasts. Don't wait until you're 40, bring it to the attention of your physician," Hurley urged. "You're your best advocate, especially Black women. The worst thing that can happen when they speak up, is that they're wrong. It's better to be wrong but safe." Local resources for women battling breast cancer suggested by Mautner include BRCA Strong, founded by breast cancer survivor Tracy Milgram-Posner, and 305 Pink Pak, created by one of Mautner's patients. The Miami Times is the largest Black-owned newspaper in the south serving Miami's Black community since 1923. The award-winning weekly is frequently recognized as the best Black newspaper in the country by the National Newspaper Publishers Association.