TRUCKEE, Calif. – For women who engage in regular screenings, there is a 50% decrease in breast cancer mortality.

“People need to take their healthcare by the horns,” Sadie Wangler, Director of Diagnostic Imaging at Tahoe Forest Hospital, said.

Especially when it comes to breast cancer, which accounts for 12.5% of all new global cancer cases, making it the most widespread form of cancer worldwide. However, through early detection and advancements in technology, we can give breast cancer a run for its money.

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Let’s quickly review the statistics. In 2022, there were 2,710 cases of invasive breast cancer in men, resulting in a lifetime risk of 1 in 833. Approximately 13% or 1 in 8 women will develop invasive breast cancer in their lifetime. Among newly diagnosed cancers in women, 30% will be breast cancer. Unfortunately, it is projected that 43,250 women in the US will lose their lives to breast cancer in 2023. In California, which accounts for 10% of the population, 4,325 women will perish from breast cancer. It’s been proven that early detection can save half of these women’s lives. That’s a potential 2,162 lives saved.

Those numbers came from a free community Breast Cancer Prevention Q & A Dr. James Schlund, radiologist at Tahoe Forest Health System gave on Thursday, Oct. 19, at the Tahoe Forest Center for Health.

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According to Dr. Schlund, the utilization of AI has yielded significant benefits in breast cancer detection. Firstly, there has been a 40% increase in the cancer detection rate, nearly doubling from its initial figures. Secondly, the call-back rate has been reduced to below the national average.

Additionally, AI has enabled the identification of progressively smaller cancers, leading to a shift toward less aggressive treatment methods and emphasizing the importance of early detection. Dr. Schlund describes AI as a “Synthetic invisible colleague reading with us in real time.”

Derek Baden, Director of Gene Upshaw Tahoe Forest Cancer Center, believes that healthcare has historically been too reactive. Dr. Schlund echoed this sentiment but is optimistic that, “medical care is moving from illness event based care where we waited for someone to present with a palpable mass or what would be likely advanced cancer, to what is now pre-emptive care based on high resolution 3D imaging and augmented intelligence finding small curable cancers.”    

Genius AI was implemented at Tahoe Forest Hospital on April 1, 2022. The technology aids radiologists by identifying breast cancers, outperforming 2D mammography. Its deep-learning AI pinpoints suspicious areas, overcoming challenges like dense breast tissue and successfully detecting breast cancer earlier. Genius analyzes pixels in 3D mammography images, providing a thorough assessment faster than humans. The future lies in predictive care, utilizing AI to forecast events and enhance wellness.

What follows is an overview of the most common questions and answers. 

How much do regular screenings decrease my chances of acquiring more serious stages of breast cancer?

Randomized controlled trials provide evidence that regular screenings effectively lower breast cancer mortality rates. Out of women who succumb to breast cancer, 70% were not part of the screening program, accounting for only 20% of participants. Again, evidence shows that for those who engage in regular screenings, there is a significant 50% decrease in breast cancer mortality. 

Detecting breast cancer at an early stage offers significant advantages. To illustrate, individuals diagnosed with Stage 1 breast cancer have a 99% chance of surviving for five years. At Stage 2, the survival rate is 93%, at Stage 3, it drops to 73%, and for those with Stage 4 breast cancer, the survival rate plummets to a markedly lower 22%. 

To really drive this point home, women who underwent yearly screening mammograms experienced a 50% lower likelihood of a terminal outcome within a decade of diagnosis. Additionally, those who were not screened annually saw only a 29% reduction in breast cancer-related fatalities.

“Although there have been many recent breakthroughs in breast cancer research and treatment, the most uplifting for me is the ability to sit with a patient recently diagnosed with a tiny cancer and let her know that from the gift of an early diagnosis, she can expect a durable cure and sleep in the comfort that preventative care and screening saved her life,” Dr. Schlund said.

Cancers now range in size from smaller than a dime to as tiny as a green pea. 

How much does treatment cost? 

The expense of treatment greatly depends on the stage of detection. Treatment for Stage 1 amounts to $43,530, for Stage 2 it’s $66,472, for Stage 3 it’s $103,800, and for Stage 4, the cost escalates significantly to $223,568. In a 2019 two-year study on overall healthcare costs, patients receiving chemotherapy incurred expenses of $200,045, while those without chemotherapy costs totaled $80,870.

This presents a significant difference in expenses, highlighting the potential savings that could be achieved through early detection.

“For women diagnosed with breast cancer, they should be comforted in the knowledge that we are tailoring care down to the unique needs of an individual with precision medicine making tremendous inroads into cure and management of cancer,” Dr. Schlund said.

Refer to #6 under “How can I take my breast and overall health into my own hands?” section for information about how low-income individuals can obtain free breast and cervical cancer screenings and diagnostic services.      

When should I start screenings? 

The American Society of Breast Surgeons, in conjunction with the American College of Radiology, Society of Breast Imaging, American College of Obstetricians and Gynecologists, and the National Comprehensive Cancer Network, collectively recommend that women start annual screenings at the age of 40. Postponing the initiation of screenings and extending intervals between them can lead to the development of larger tumors, necessitating mastectomies, chemotherapy, radiation therapy, incurring higher costs, increasing the likelihood of recurrence, and potentially resulting in loss of life. 

How do I know if I’m at high-risk for breast cancer? 

Several factors can increase the risk of breast cancer. These include genetic mutations, such as alterations in genes like BRCA1 and BRCA2, reproductive history with early onset of periods and late menopause, and a family history of cancer among first-and second-degree relatives. Additionally, even if no cancer is found, a history of breast biopsies can be a risk factor, along with increased breast density and exposure to light during night shifts. Other considerations encompass dense breasts, a high body mass index, and a cumulative lifetime breast risk of 20% or higher, which categorizes individuals as high-risk. 

What if I have dense breasts? 

According to Dr. Schlund, dense breasts are so dangerous because they obscure cancers with gloppy breast tissue. “Dense breasts are like looking at a Jackson Pollock painting,” Dr. Schlund continues, “But AI is extremely good at looking for a needle in a haystack.” AI actually digs through breast tissue volumetrically in three dimensions. 

Additionally, MRIs are advised for women with dense breast tissue. Nevertheless, it’s worth noting that they may not be presently covered by insurance, and obtaining insurance approval could be a time-consuming process.

How can I take my breast and overall health into my own hands? 

For further information about your risk, visit Ibis-risk-calculator.magview.com. All women should calculate their risk at the age of 25. Discuss your results with your Primary Care provider during your next visit to assess whether you are at a high risk for breast cancer and to plan for annual screening.

Get genetic testing. Nowadays, this service is available for as low as $100. “I think we’d be wiser and live smarter lives if we knew our genetic predispositions. It’s the cost of going to Costco,” Dr. Schlund said. Tahoe Forest offers Invitae Genetic Screening, which never exceeds $250. Genetic testing is extraordinarily powerful for those high risk and who have a family history of breast cancer. In fact, 75% of all breast cancers occur randomly, without any apparent cause. In the remaining 25%, a problematic genetic history within the family can be identified. 

Join the WISDOM study and be part of a movement to revolutionize breast cancer detection. Recommended for high-risk women at the age of 25. Your participation will make a positive impact on both your own well-being and that of future generations. Led by doctors and researchers at the University of California, in collaboration with medical centers nationwide, the WISDOM Study aims to uncover the most effective approach to detecting breast cancer, ultimately leading to healthier, cancer-free lives for all women.

As a participant in WISDOM, you’ll receive top-notch breast screening recommendations. Additionally, you’ll gain insights into your personal breast cancer risk and learn strategies to mitigate it. Upon receiving your risk and genetic results, you will be provided with a personalized schedule tailored to your specific circumstances.

To be eligible, you must: 1) Identify as female, 2) Be aged between 40-74, 3) Reside in the United States, and 4) Have no history of breast cancer or ductal carcinoma in situ (DCIS).

Here’s how you can get involved: 1) Register for the WISDOM Study at Thewisdomstudy.org. 2) Complete online questionnaires regarding your breast health. Some participants may provide a saliva sample to assess personal risk factors. 3) Receive your personalized WISDOM recommendation on the timing and frequency of your mammograms. 4) Complete an online health survey at the conclusion of each study year. For further inquiries, contact (855) 729-2844.

Make sure to keep up with your screenings. Remember, early detection can make all the difference in your outcome. Navigate to Tfhd.com/mammograms and call (530) 582-6510 to schedule an appointment without an order! Every woman over 40 should have annual screenings. 

Regular self-examinations for breast health have now been superseded by annual clinical breast exams conducted by your primary care provider. Contemporary research has raised concerns about the anxiety that can be triggered by regular self-exams. Therefore, it is advised to prioritize annual healthcare maintenance and wellness check-ups instead.

Explore Every Woman Counts, a program offering complimentary breast and cervical cancer screening and diagnostic services to underserved communities in California. The program’s mission is to alleviate the profound medical, emotional, and financial impacts of breast and cervical cancer while addressing health disparities for low-income individuals.

This program was designed to assist individuals who lack insurance and face obstacles within the system. Thanks to Every Woman Counts, individuals can access essential care they might not otherwise receive, including screenings, diagnostic evaluations, and biopsies. Visit Dhcs.ca.gov/ for further details and to determine your eligibility. 

What general resources are available for support at the Gene Upshaw Memorial Tahoe Forest Cancer Center? 

Despite being a relatively small community, the Gene Upshaw Memorial Tahoe Forest Center is extraordinarily sophisticated. Dr. Schlund refers to it as “The mouse that roared.” It’s unusual for a center of this size to have both radiation oncology and a PET/CT scan on-site.

In addition, Gene Upshaw provides a range of complimentary supportive care programs. These cancer-specific support initiatives are integral to a patient’s overall treatment plan. The center takes a comprehensive approach to addressing psychosocial needs before, during, and after treatment, encompassing social, psychological, emotional, and functional aspects to enhance the quality of life for both patients and their families. Navigate to Tahoecancercenter.com to read about oncology support services.

For Financial Assistance Information, dial (530) 582-6510. Contact the Tahoe Forest Hospital Community Health and Center for Health Teams at (530) 587-3769. Reach out to Sadie Wangler, Director of Diagnostic Imaging, at (530) 582-6574. To contact Dr. James Schlund, dial (530) 582-6584.

Starting late Spring, Tahoe Forest will extend mammography services to the Incline Village Hospital. This expansion will be particularly beneficial for Nevada Medicaid patients, as coverage often does not extend across state lines.

Any updates from the American Cancer Society? 

According to Karen Knudsen, CEO of the American Cancer Society, there are currently 161 active research grants amounting to $123.7 million. Notably, significant progress has been made in the understanding of triple negative breast cancer, which disproportionately affects women with this diagnosis.

Research indicates that estrogen can trigger the formation of brain metastasis in triple-negative breast cancer, operating through an estrogen-sensitive pathway in neighboring glial cells. This sheds light on the higher occurrence of brain metastasis in pre-menopausal triple-negative breast cancer patients and suggests that therapies blocking estrogen may be effective in preventing such metastases.

Additionally, the analysis of cell-free DNA has emerged as a valuable tool for clinicians, offering a non-invasive means to monitor disease progression through blood tests, eliminating the need for biopsies.

Wendy Damonte, Executive Director of the Martis Camp Foundation, experienced the loss of her mother, Diane Wyness, due to triple negative breast cancer. The diagnosis was particularly shocking as Wyness had received a clean mammogram just a few months prior.

However, this was in a time before the advancements of AI and improved medical technology. Wyness had dense breast tissue, which obscured the cancer in the mammogram. Remarkably, 40% of women share this characteristic.

In response to this, Damonte co-founded a nonprofit organization called Each.One.Tell.One. Its mission is to raise awareness among women about dense breast tissue and the screenings capable of detecting it. This initiative was born out of Damonte’s deep desire to honor her mother and her hope that increased awareness, coupled with advancements in screenings and technology, will ultimately render breast cancer a fully conquerable disease.

Armed with actionable knowledge, we’re well on our way.

To learn more about Damonte’s organization, visit http://eachonetellone.org/.