Zainab Balogun: Mammograms are essential, and so are self-exams

This past year I was fortunate to be chosen as an Albert Schweitzer fellow and was tasked with continuing an established project dedicated to improving the health literacy of underserved women at our city’s prominent free clinic. This project is aimed at not only educating women on the basic aspects of breast cancer, arming them with the knowledge needed to seek informed care, but also providing them with vouchers to receive free mammograms across the city.

While this experience has been immensely rewarding, it hasn’t been without its challenges, particularly pushback from patients who don’t think performing a mammogram is as important as getting their heart health in check, or from women who think self-examinations don’t do anything. All of which is understandable: We all have a tier list of issues we need to solve. If I’m living with hypertension and actively seeking to reduce my blood pressure, having to add another health care goal like getting a mammogram already seems daunting.

But the fact of the matter is that breast cancer remains the most common cancer type in the United States. In 2022, there were approximately 290,000 new cases of invasive breast cancer with approximately 44,000 women dying of the disease. Despite the many advances made to treat it, we still have women dying of breast cancer. Thus, breast cancer screening is just as important as getting one’s heart health in order.

Breast cancer screening, a fundamental component of early detection, has been cited as the key to reducing the risk of death. While it has been lifesaving to thousands of women, its progress has not been equal. There’s still an underutilization of screening tools like mammograms by Black, Hispanic and many other underserved women.

Black women die from breast cancer at higher rates than white women, even though Black women have lower breast cancer incidence rates. The same applies to all women who are uninsured, immigrants or underserved in any way.

The reason for underutilization is multifaceted: Black women and other underserved populations are less likely to have geographic accessibility to mammography screenings, insurance to afford such screenings and adequate information to be more informed about mammograms or breast cancer. In addition, cultural beliefs and negative experiences within the health care system can serve as barriers that further hinder patients’ access to mammograms. Issues like these are why scientific studies propose strategies that are multifaceted, patient-centered and culturally congruent.

This served as the basis for our project with the free clinic. We seek to not only provide these mammograms to patients but also to educate and have them understand why they need to undergo a mammogram. My ultimate goal is to assuage patients’ worries and provide them with the knowledge they need to make an informed decision on their health.

In addition to providing facts about breast cancer, I encourage patients to perform self-examinations. Self-examinations, which have been controversial recently for their lack of usefulness in improving outcomes, are still very important. Consistent attention to the breast allows a woman to understand what is normal and what isn’t. Self-exams play a valuable role in early detection.

It has been shown that health literacy improves adherence to breast cancer screening. This is a call to action for an increase in similar programs like ours to increase access to early detection, particularly for underserved women. I see a future where patients are not only strengthened with knowledge about their breast health, making them confident about the decisions made regarding their health, but also have improved outcomes due to increased access to early detection.