Breast Care - Screening for Breast Cancer

Joanne Genet, MA, PA

Being a lesbian does not increase a woman’s risk of breast cancer but some life style differences between lesbians and heterosexual women might.

These differences may place them more at risk:

• None or few full-term pregnancies

• Increased body weight in comparison to hetero­sexual women and bisexual women

• Lower income and the resulting difficulty paying for health care

• Lack of health insurance coverage

• Fear of homophohic medical environments 

Lesbians also face unique challenges in getting screened and treated for breast cancer.
Do you know how this affects you?

One in eight women will develop breast cancer at some point in her lifetime. If diagnosed early, breast cancer can usually be treated successfully. In fact, the five-year relative survival rate for localized breast cancer is more than 95%.

RISK FACTORS

Age: approximately 70% of women with breast cancer have no known risk factors beside age and gender. Age is by far the most significant risk factor. By age 50, all women should receive a clinical breast exam and a mammogram.

Family history: having a direct relative (mother, sister, daughter) with breast cancer may indicate a higher risk. It is estimated that only 5 to 10% of breast cancers are inherited. This means that 90-95% of breast cancers have other unknown causes.

Early detection of breast cancer is our best protection.

RELATIVE RISK FACTORS:

Increased estrogen levels: some researchers believe that anything that increases a woman’s lifetime exposure to estrogen may also increase her breast cancer risk. This includes:

• No full-term pregnancy

• Full-term pregnancy after the age of’ 30

• Young age at first period (before age 12)

• Late menopause (after age 55)

• High body weight (increased body fat)

POSSIBLE RISK:

• Hormone replacement therapy/estrogen supplements! oral contraceptives: studies are conflicting about hormone usage and breast cancer risk.

• Smoking: smoking has been shown by some researchers to increase the risk of breast cancer.

Alcohol: drinking two or more alcoholic drinks per day has been shown by some researchers to increase the risk of breast cancer.

• Environmental factors: it is suspected that certain environmental factors and chemical exposures may increase the risk of developing breast cancer, but these links have not been proven.

HOW IS THIS SIGNIFICANT TO LESBIANS? 

Although being a lesbian has no direct affect on one risk of developing breast cancer, there are certain risk factors that tend to be more common in lesbians.

Lesbian risk factors: since a lesbian may give birth to no or few children and is more likely to have high body weight, both of these increase risk.

Lower income and lack of health insurance: lesbians generally have lower incomes and are less likely to have health insurance coverage from their partner or themselves. This makes paying for screening and preventive health services more difficult. Early detection and t reat nsent increase a woman’s chance of survival.

Experiencing homophohia: many lesbians have had previous bad experiences with the medical establishment and fear of disclosure. The impact of homophobia limits many lesbians from making needed medical appointments.

In California, there is a free breast health screening program for women 40 years old and older who are underinsured or uninsured and low income. Find out where these services are near you.

Call (800) 511-2300 for a breast health referral.
 

HOW TO FIND A LESBIAN FRIENDLY HEALTH CARE PROVIDER

Ask questions. Visit or call (which you can do anonymously if you prefer) your doctor, hospital or clinic and ask if they treat lesbians. Ask if they have a non-discrimination policy that includes sexual orientation and gender identity. Ask if the staff has received any training on lesbian health issues. Ask about their confidentiality policy and whether patients can be sure of maintaining their privacy.

Get referrals. Ask friends, visit GLBT community centers, women’s health clinics, check newspapers, ask friends if they know a health care provider you might be comfortable with.

See Links and Related Resources
 

SCREENING FOR BREAST CANCER

THE BREAST SELF EXAM (BSE)

A breast self exam is a thorough examination of your own breasts. Starting at age 20, this should be done once a month after your period (or at the same routine time each month). The American Cancer Society has information on how to do a breast self exam. When you have your clinical breast exam, ask your medical providers to teach you how to do your own breast exam.

THE CLINICAL EXAM

Starting at age 20, get a yearly clinical breast exam from a heath care provider. During your visit, ask for information that can help you know your breasts better and to be taught how to do your own breast self exam.

MAMMOGRAMS

A clinical breast exam and a mammogram are both needed to check for breast changes. At 40 years old, a woman should consult her health provider about how often to have a mammogram. After age 50, a woman should have a yearly mammogram.

A mammogram is an X-ray of the breast that can detect changes in the breast years before they can be felt.

Women at high risk for breast cancer may want to get a mamnmogram at an earlier age. Consult your health care provider to determine when you should begin getting mammograms.

To find out where you can get a mammogram, call

• (800) 227-2345 The American Cancer Society

• (800) 4-CANCER screening referrals

• (800) 511-2300 California Breast Cancer Early Detection Program - 
free breast exams, mammograms, and follow up for low-income and underinsured women over 40.

This brochure was made possible by funds received from the Contra Costa Breast Cancer Partnership, State Breast Cancer Fund, Cancer Detection Section, California Department of Health Services, and produced by the Rainbow Community Center of Contra Costa County.

Rainbow Community Center
2118 Willow Pass Road, Suite 500
Concord, California 94520

telephone (925) 692-0090
email [email protected]