African American women are diagnosed with breast cancer at a younger age and with more aggressive tumor biology, so early diagnosis is critical,” says Violet Merle McIntosh, MD, chief of breast surgery at Englewood Health.

“Fear prevents many women from getting screened, because they believe
that a diagnosis of breast cancer is life threatening,” she adds. “The reality is
that most women who are diagnosed early will survive.”

When should I have a mammogram?
“The American College of Radiology (ACR),” says Dr. McIntosh, “recommends
that women with an average risk of developing breast cancer begin annual
screening mammography at age 40.

“Women at high risk of breast cancer should begin annual screening 10 years
earlier than their first-degree relative (mother, sister, daughter) was diagnosed
with breast cancer or a BRCA gene mutation, but not before the age of 25.

“The big message here,” she says, “is to participate in screening. Our challenge
is how to get patients over the fear. It is what paralyzes most women.
Today, a large majority of women with early-stage cancer are cured—another
reason for regular screening. We need to share this message: A diagnosis of
breast cancer is not a death sentence. Get screened—get a mammogram and other related tests, if needed. Just do it!”

What about my family history?
“I encourage all women to familiarize themselves with their family medical
history,” says Dr. McIntosh. “If you have “ a strong family history of breast cancer, you need to be screened differently.”

“Many people don’t know their family history,” she adds. “Such things were
not talked about in the past. Family members might have known something
was wrong with Grandma, but they didn’t know what. Ask questions! Reach
out and find out what this person had. I encourage all African American women to talk to the women in their lives— mothers, grandmothers, aunts, cousins. Talk with them and get the information.”

Does what I do really matter?
“Our lifestyle can impact what happens to us. Lifestyle-related causes of
breast cancer include alcohol abuse, smoking, and obesity,” says Dr. McIntosh.
“Some studies, for example,” she says, “have found that patients who gain weight after having had breast cancer are more likely to have a recurrence.
We have to look at our health in general and try to work toward overall good health.”

Why did you decide to specialize in breast surgery?
“When I was in my first year of medical training,” says Dr. McIntosh, “I saw
a lot of breast surgery. Breast surgery deals not just with surgery, but with interpersonal relationships with patients and with counseling them. You really
get to know the patients. It was a good fit for me.”

What do you find most rewarding about being a breast surgeon?
“Getting to know patients personally, understanding where they are at and
what they are about. Cancer diagnoses often seem to occur at the most inopportune time—when a first grandchild is due or a patient is about to get married. We can work with the patient, try to accommodate
important events in the patient’s life, while providing the best care
we can.”

Doctor’s Orders:
1.) Take charge of your health
2.) Know your family history
3.) Follow screening guidelines
4.) Consider how lifestyle decisions can impact what happens

African American Women and Breast Cancer Facts
• The #2 cause of cancer death (after lung cancer) in African American women
is breast cancer *
• Black women who develop breast cancer tend to be diagnosed at a younger
age than white women **
• African American women are 42 percent more likely to die from breast
cancer than non-Hispanic white women, despite roughly equal incidence rates **** American Cancer Society
** Susan G. Komen Foundation
*** American College of Radiology

Violet Merle McIntosh, MD, is chiefof breast surgery at Englewood Health and a member of the leadership team at the Leslie Simon Breast Care and Cytodiagnostic Center and at the Lefcourt Family Treatment and Wellness Center at Englewood Hospital.