Beating Breast Cancer in the Bronx

By Dr. Sheldon M. Feldman, chief, Division of Breast Surgery & Breast Surgical Oncology and director, Breast Cancer Services, Montefiore Einstein Cancer Center; professor, Albert Einstein College of Medicine and Dr. Della F. Makower, medical oncologist at Montefiore Einstein Cancer Center & associate professor, Albert Einstein College of Medicine

HEALTH - In the United States, breast cancer is the most common cancer in women, aside from skin cancer. Nationally, about 1 in 8 women will develop breast cancer. In New York, 6,300 women are newly diagnosed each year. 

Closer to home, we see a little less than 1,000 new breast cancer cases in the Bronx annually. While we are making major strides in treatment of breast cancer, early detection is still key for survival and ensuring we can provide the widest array of therapeutic options.

The earlier breast cancer is found, the survival rate is improved, less severe treatments are needed and a person’s normal breast appearance can be maintained. Early detection is a combination of at-home awareness and in-person care from your doctor and nurse.

Most breast changes have benign “non-cancer” causes, and might look like a bruise or a bump. Sometimes these changes could be a signal of disease – if you have concerns, don’t hesitate to reach out to your primary care provider.

When to Start Breast Cancer Screening

At Montefiore Einstein Cancer Center, we recommend starting mammograms at age 40. We have the most accurate breast imaging screening with 3D tomosynthesis mammograms, this is an imaging test that combines multiple breast x-rays to create a three-dimensional picture of the breast. 3D tomosynthesis mammograms enable us to look for breast cancer in people who might have no signs of disease.

Earlier screening and supplemental breast ultrasound and MRI are indicated for women at increased risk based on family history, genetic mutation or abnormal biopsy. We also have a high risk breast cancer surveillance program at Montefiore Einstein Cancer Center so people coming in for screening can receive personalized screening and prevention recommendations. In addition to regular screenings, a healthy lifestyle with regular exercise and nutritious diet are important for prevention. 

Taking breast detection a step further, we held our 14th annual Edward S. Greenwald, M.D., Breast Screening Event. During this time, women can receive same-day breast exams and screening mammograms. This event was free for women without insurance, including people who are undocumented.

A Team-Based Approach to Treatment

From detection to treatment, it is important to know that cancer care is all about having a team.

Dr. Sheldon M. Feldman, chief, Division of Breast Surgery & Breast Surgical Oncology and director, Breast Cancer Services, Montefiore Einstein Cancer Center; professor, Albert Einstein College of Medicine and Dr. Della F. Makower, medical oncologist at Montefiore Einstein Cancer Center & associate professor, Albert Einstein College of Medicine

Central to successful breast cancer treatment is having a multidisciplinary team including: oncologists, cancer surgeons, reconstructive surgeons, social workers and support staff so that each person who comes through our doors has a personalized treatment program. Our National Cancer Institute-designated cancer center helps us bring access to many clinical trials so Bronx residents can benefit from the newest and best treatments options. 

Some examples include: non-surgical tumor ablation and intra-operative radiation, a form of breast conservation therapy that involves radiation being delivered at the same time as surgery, allowing people to have fewer treatments and potentially fewer treatment-related side effects. We also offer immunotherapy, and other new medications. 

To support much of this work, we recently earned an American Cancer Society grant so we can add navigators to streamline appointments, such as imaging studies, lab assessments and treatments, for individuals with locally advanced, non-metastatic cancer who would benefit from neoadjuvant therapy (NAT), which is intended to shrink a tumor prior to surgery. This new initiative is particularly important in the Bronx, where only 60% of our patients at Montefiore complete all intended NAT visits and up to 40% miss at least one due to treatment toxicity or socioeconomic factors like lack of transportation. We feel confident that these additions to our staff will benefit many of our patients. 

Today, we are more equipped than ever before to deliver the very best care for everyone with cancer. This October, Breast Cancer Awareness Month, prioritize your health and don’t forget to get screened.