Tuesday, April 7, 2009

How Well Do You Know Your Boobs?

I’m having a hard time with this blog entry because I don’t want to point the finger at anyone (especially someone who should know better about this topic), so bare with me as I try to discuss a subject near and dear to my heart.

Some of my readers may know that I’ve had some breast “issues” in the past, that is 2 biopsys, one with a diagnosis (dx) of atypical ductal hyperplasia (ADH) and the other benign, but florid. Now the first dx is a little tricky because I’ve since learned that one pathologist’ ADH dx is another’s Ductal Carcinoma In Situ (DCIS). In other words benign versus malignant. Yeah , YIKES!!! I’ve also learned that a woman can inherit the propensity to have breast tumors from her father, and I’ll repeat that. A WOMAN CAN INHERIT THE PROPENSITY TO HAVE BREAST TUMORS FROM HER FATHER. So in my case, there’s a branch of the family where ALL of the women except one, have either had breast cancer, ovarian cancer or both and I’m almost certain it’s due to mutations in the BRCA1 gene). My father also died from adenocarcinoma of the colon and prostate cancer (PC) and it’s in the PC Dx that the correlations between lies (not strong info proving this as of the last time I checked it out 4 years ago, but from my own cancer epi work, I noticed a higher than normal incidence of PC in BRCA1 families).

Most people with even a cursory knowledge if genetics knows that African genes tend to be highly penetrant. In other words, Obama looks like a regular ol’ lightskinned brotha feature wise, due to his having an African father. So it stands to reason that, Black women in America tend to have the same issues with breast cancer as woman of “purely” African decent, those issues being Dx’ed at a later stage and higher grade, and a higher death rate from the disease compared to all other racial groups.

Now I suspect ALL Black Americans living in America ( excluding those 1st and 2ndgenerations with parents from Africa) have genetic profiles that include just about EVERY major race on the planet. For example, my own background is African, Native American (Cherokee), Irish, Spanish, and Jewish ( OK, OK, I KNOW Judaism isn’t a race). So because I’ve always known that I’m not a “majority” of ANY race genotypically (although I check the Black box), I insisted on having a baseline mammogram at age 33 instead of age 35 after my father was Dx’ed with prostate cancer. Turn’s out, it’s a dam good thing I did since that was also the Dx of ADH, a precancerous lesion (my past 3 years of mamo’s have been great thanks I believe in large part to some lifestyle changes I’ll discuss in a later post).

After I finished my fellowship at the NCI in 2005, I decided then that I would tell EVERY person I knew of ANY level of African decent to get a baseline mammogram at 30 instead of waiting until age 35. With black women getting diagnosed earlier than every other race of women with more highly aggressive and highly fatal breast cancers, it’s simply prudent to err on the side of caution even if your insurance won’t pay the bill. Luckily, most metropolitan communities provide Mammo’s for minority women either free or charge or at a reduced rate, so no excuses here ladies. Ironically, in 2007, I read an article by a renown Black female breast cancer specialist who was now recommending Black women get baselines at age 30 (I actually met her in 2005 and shared my thoughts about this with her).

So what is this post really about? It’s about protecting your cleavage. It’s about the fact that even if you look like Vanessa Williams with her blondish hair and blue eyes, Halle Berry, AND Beyonce’ combined, those few onces of “black blood” should tell you breast wise, things may be different for you so you’d be wise to act accordingly. Get that baseline at age 30.

FYI, this year I’ll once again be participating in both the Avon walk for the cure and the SG Komen Race for the cure so if you have any questions, drop me a line at msapas1@yahoo.com!!!

*This post is NOT an attempt to give medical advice simply to share my persopnal experiences and opinions

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