During the pandemic, many people have postponed routine health care screenings including breast exams. Breast Health Awareness Month is a great time to remind everyone to get the health care they may have been putting off – that includes yearly evaluations, screenings, and mammograms.
“I strongly encourage people to continue with preventive health exams and studies. Mammograms are recommended by the American College of Obstetricians and Gynecologists every 1 to 2 years from the age of 40. During the pandemic, many people were either asked to delay their screening tests and visits or had fear of coming in to their health care provider. In some cases, this has led to a delay in diagnosis, making cancers like breast cancer more difficult to treat due to being found at a more advanced stage,” said Planned Parenthood of the Pacific Southwest Chief Medical Officer Antoinette Marengo, MD.
Physician Assistant Sally Ortega said she has noticed many people coming in for routine care to include breast health exams, cervical cancer screening, and STI tests after putting it off for far too long because of the stress and mental health issues brought on during the pandemic.
“We are only now starting to see the mental health effects of the pandemic, and that is going to emerge as a larger health care concern in the future,” Sally said. “I have seen the effect it has on our patients already, and it has definitely been a barrier to getting care.”
Each year, clinicians at our 19 health centers in San Diego, Riverside, and Imperial counties conduct almost 7,000 breast exams. Each year as many as 1,000 patients are referred for advanced screenings like mammograms, appointments with surgeons for biopsies, and other advanced care. Director of Clinical and Nursing Support Karin Schlosser helped many of these patients get the care they need.
“Each person who gets breast health care at our health centers is getting the highest standard of care because I review all imaging results personally and follow up with the patients as indicated to make sure they have all their questions answered and they have gone to their appointments,” Karin said.
She helps many patients navigate the health care system to get an appointment. Once patients have gotten advanced care and screenings, she follows up with their provider so that she can note the results. Each year, 10 to 12 people are diagnosed with breast cancer after being initially screened at Planned Parenthood of the Pacific Southwest. These patients are usually women in their 30s and 40s who live in Riverside and Imperial counties.
“Women in these regions have less access to health care than women in San Diego and those numbers have been steady for many years,” Karin said.
Our clinicians routinely perform breast exams, make diagnoses, and refer for further screenings, and specialists. Sally said that many patients say the counseling they receive at these visits is just as important as the screening itself. She shows patients when and how to monitor for changes in their own breasts that may require another visit to a health care provider.
Sophia is one of the many people who received their first breast exam at Planned Parenthood as part of their yearly evaluation and screening or YES! visit. “I really appreciated the way the clinician was super patient and took the time to explain what she was going to do and when I would feel her fingers on my breasts. And I liked that she used really accessible terms that I was able to understand. It was my first breast exam, but I didn’t feel intimidated because I feel really comfortable at Planned Parenthood.”
Sally recently cared for a patient who presented with symptoms with a high suspicion for breast cancer. “Providing health care is part of the job, the other part is providing that emotional support so they can get the care they need.”
Both Karin and Sally praised California’s Every Woman Counts program, which provides people who have no insurance with breast cancer screening and treatment.
“It is very easy to get signed up for this program and get care the same day,” Karin said.
Access to health care is critical for the survival of people who are diagnosed with breast cancer, particularly people in Black and Latinx communities who face systemic barriers to care.
“It is race that will affect your health care. If you are brown or black you have a higher likelihood of not getting the care you need, not because of a genetic risk factor, not because of socioeconomics, it’s because people in these groups don’t have the access to continuity of care,” said Sally, who is a leader in Planned Parenthood’s ongoing commitment to reverse health care disparities.
“There have been numerous research studies that show that black women die at a higher rate from breast cancer. The information on the disparity is there. But you won’t find a lot of guidance on how to overcome these race-based health disparities.
“Even when diagnosed at similar ages and stages and with similar tumor characteristics, Latinx women are more likely to die from breast cancer than non-Latinx white women. Breast cancer is the leading cause of death among Latinx women.
“At Planned Parenthood we are doing a variety of things to reverse these disparities including providing access to health care, providing nonjudgmental care, community engagement, training staff on how to care for people who face barriers to care based on their immigration status, being transparent in our care, allowing patients to pay with cash, and we minimize complications for communities that are battling limited access to care,” Sally said.
Learn more about breast cancer health care disparities in this article from the National Institutes of Health.
Learn more about breast health and screenings.
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