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Executives talk facts about breast cancer
by Melissa Wasserman

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Breast-cancer awareness is highlighted in October, but if you ask any health center, breast health is important to pay attention to all year round.

Connie Oliver, vice president of communications and marketing at Solis Mammography, said October is the busiest month of the year for mammograms, with November running a close second.

Solis Mammography specializes in breast imaging services and serves more than 600,000 patients each year with screenings and diagnostic mammography ( 2D and 3D ), computer-aided detection, breast ultrasound, stereotactic biopsy and ultrasound-guided biopsy. Headquartered in Addison, Texas, Solis operates 40 centers across six major markets and has multiple joint ventures with hospital partners.

In the entire female population, of women over the age of 40, regardless of sexual orientation, who have health insurance, Oliver said, only 54 percent get their annual mammogram. While Solis serves men and women, according to clinical operators Oliver has asked, about 2 percent of patients are men.

"It isn't just an indication if something is wrong or not, but for women ages 40 and up, they get their screening as a preventative health measure and it is covered by insurance," Oliver said. "So, they're perfectly fine, nothing is wrong, but they're just getting their annual checkup and that's covered by insurance. For a man, he is not covered by insurance for a screening unless he has a problem."

"We fight the same issue with any female, regardless of sexual orientation, which is educating them to understand this is about more than just saving your life," said Oliver. "This is about giving you greater quality of life because the earlier you know, the better your options are."

Oliver added that women should regard mammograms as normal and routine, just as they might any other medical check-up.

"For me, it is not about breast cancer, it is about breast health, and so while the month of October focuses largely on survival of the pink ribbon and the women who have fought and continue to fight against breast cancer, and we applaud that, for any women, this should be just a regular part of our health and wellness checkup because the average size of something, when they find something in a mammogram, is the size of a pea," said Oliver. "The average size when they find it in self-exams, is the size of a walnut. If you just consider from a common sense [perspective], in layman's terms, think about just how much it costs, how much more invasive the treatment is and how much more stress is put on your body when you are trying to take care of the walnut instead of the pea."

Oliver said the biggest misconception within the topic of breast health is that a mammogram is just a mammogram and it doesn't matter where you go. When somebody goes to a breast center for a mammogram, she emphasized, they should look for someone who offers 3D technology. If they don't offer 3D technology, she said, then find somewhere else.

Oliver wrote an article titled, "Ladies Let's Talk About Breasts ... Breast Health, That Is." In the article she writes: "It's bad enough that 230,000 women were diagnosed with breast cancer in the United States in 2015 alone, but it's even worse when you learn that—according to the American Cancer Society—the LGBT community of women has higher rates of breast cancer than heterosexual women. This may be because women who haven't had children, haven't breast-fed, haven't used oral contraceptives, or are older when they first give birth are at a higher risk for breast cancer."

Oliver also writes that according to the American Cancer Society, some of the reasons for the fewer number of checkups with LGBT+ women include lower rates of health insurance, as many policies still do not cover unmarried partners, which makes it harder for many individuals in this community to get quality healthcare; discrimination or fear of discrimination as many women are afraid to tell their doctors about their sexual orientation because they're afraid it will affect their quality of care; and negative experiences, meaning having negative experiences with doctors or other healthcare providers that can result in some women either putting off routine checkups ( like mammograms ) or even skipping them altogether.

Amy Nicole Miller, manager of women's health services at Howard Brown Health, confirmed that lesbian, bisexual and queer women ( both cisgender and transgender ) are less likely to be insured than their heterosexual counterparts, which is one reason why LBTQ women are not getting checked for breast cancer each year.

A second reason is the more common experience of discrimination or trauma in healthcare settings.

"We don't go to the doctor as often as we would in an ideal world," said Miller. "Trans women in particular experience a lot of harm in healthcare settings. This means that breast cancer screenings may not happen, unless these women have an LBTQ-affirming healthcare provider. Transgender men are unlikely to be screened for those same reasons, in addition to maybe thinking they cannot get breast cancer after having had top surgery. When any breast tissue remains, there is a chance for cancer in their chests, especially if there is a history of breast cancer in their family."

Thirdly, outreach and education for breast cancer awareness, Miller said, is very much targeted to straight cisgender women.

"The whole concept behind the pink ribbon campaign is blatantly disregarding anyone who isn't straight, cisgender and feminine," Miller explained.

In terms of breast-cancer susceptibility, Miller said LBTQ+ folks are more likely to participate in activities that present risk. For example, she said, smoking, drinking and obesity are risk factors for breast cancer and research has shown that lesbian and bisexual women have higher rates of all three.

"That risk is even greater when compounded with race and class, which also make one more likely to die from breast cancer as compared to white, wealthy women who have more access to quality treatment options," said Miller.

Miller explained that Howard Brown offers services such as the Sexual and Reproductive Health Drop-In, which offer clinical breast and chest exams, along with referrals for mammograms if needed, every fourth Wednesday of each month, as well as its Gilda's Club LGBTQI+ cancer support group every fourth Wednesday of each month.

"It's important to know that Howard Brown Health has LGBTQ+-affirming providers who can educate folks on their individual risks for breast cancer based on their individual history and body parts," said Miller. "We also offer provider services on a sliding scale, so that no one is turned away for lack of ability to pay. In addition, we are welcoming to everyone regardless of immigration or documentation status."

For more information on Solis Mammography, visit . For more information on Howard Brown Health, visit: .

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