With COVID-19 pandemic concerns many women canceled or delayed their first or annual mammograms. Doctors are encouraging women who missed their screenings to schedule an appointment sooner rather than later. Lynn, a patient here at TEPAS Breast Center, was one of the many women that delayed her annual mammogram – by 10 weeks. Her screening mammogram results were abnormal leading to a biopsy: Stage I invasive ductal cancer, 8mm (1/3”) in size. The breast cancer required a lumpectomy to eventually be followed with breast radiation. Although small, the cancer was aggressive enough to warrant further treatment, chemotherapy. Had she delayed her mammogram further, the cancer would have certainly grown if not spread, decreasing the odds of being cured.
Dr. Emran Imami, Medical Director here at TEPAS Breast Center, says that the biology of breast cancer tells us that it is usually present within our body years before it can be detected. His analogy is that of a pregnant friend, Susie, whom you haven’t seen in 9 months. Upon seeing Susie, one may comment in astonishment “How did you get to be so big?” Well, when Susie was first pregnant, there were two cells dividing to four, eight, sixteen and so on. Early on, no one could detect Susie’s pregnancy, however by 6-9 months, there is no hiding it.
Breast cancer is similar to this, the growth timeline however is years rather than months. That being said, we know appropriate breast cancer screening detects cancers earlier and saves lives. Numerous medical publications have attempted, however, to quantify the impact of delaying breast cancer therapy.
A literature review published in 2018 determined the optimal time to initiate treatments like surgery, chemotherapy and radiation therapy were 90, 120 and 365 days respectively . A study of 1,084 non-symptomatic invasive breast cancer in China followed patients an average of 35 months for delays in surgery beyond 90 days. The study revealed no change in survival except for patients with triple negative breast cancer. Women with triple negative breast cancer experienced a lower survival as results of delayed surgery.
The most recent and largest study addressing treatment delays evaluated 11,175 breast cancer patients in Singapore and found that a delay in surgery of > 30 days or a delay in post-surgery chemotherapy > 90 days resulted in lower survival rates for women with invasive breast cancer.
With concerns over COVID-19 Lynn’s story is a reminder that there are other health issues that should not be ignored. Early intervention and detection saves lives.
We’re here to care for you safely at every in-person appointment, including mammograms. If you have been putting off getting this potentially life-saving cancer screening, don’t delay it any longer.