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Every October, the pink shows up everywhere: ribbons, storefronts, TV ads. It's easy to tune out. But Dr. Tiffany Tonismae from UofL Health puts it perfectly- that pink is a reminder, like the oil change light on your dashboard. It's your cue to check in on yourself.

Dr. T is a maternal fetal medicine specialist. She is typically working with pregnant or newly postpartum moms and she says people assume breast cancer isn't on her radar. It is. "We do get quite a few women who are diagnosed with breast cancer in pregnancy," she told me, "which is even scarier."

Start paying attention at 40

Many of us still think of breast cancer as an older woman's disease. Dr. T says that's outdated, because it's becoming more common in women under 50. Screening guidelines vary depending on who you ask, but in general she points women to age 40 for a first screening mammogram.

She admitted, with a laugh, that she's behind too. She's rescheduled hers three times, and the thought of it is "a little terrifying." But friends who've gone told her it's easy. In Louisville, she says, you can book online through any of the major hospital systems, at multiple locations, and the appointment is about 30 minutes. (She has it on the calendar now, and promised to go before this episode airs.)

Know your history, and know what to watch for

If you're younger than 40, the most important thing you can do is learn your family history. Dr. T stressed that breast cancer doesn't only affect women. A male relative with breast cancer raises your risk too. She said only about 10 to 15-percent of breast cancers have a genetic component, but knowing your family's story helps you and your doctor make smart decisions.

Other risk factors include being a woman, getting older, and having dense breast tissue, which can make cancer harder to see.

Things to watch for:

  • A lump in either breast
  • A red, tender spot on one or both breasts
  • Nipple drainage, especially green or bloody

Any of those is worth a conversation with your doctor. Your annual visit should include a breast exam, and Dr. T wants women to speak up. "Don't be afraid to ask questions or talk about your symptoms."

Why early detection changes everything

We talked about what happens after a diagnosis: building a care team, seeing an oncologist, and usually a biopsy to learn what kind of receptors the cancer has. Treatment may include surgery, chemotherapy, or both, depending on the stage, your overall health, and what you want. Some women, especially with more advanced disease, choose a path focused on comfort.

Then she shared the number that matters most. Caught at stage one, survival rates are about 99 percent for the first five years after diagnosis. Dr. T credits earlier screening, and even the reminders that pop up in patients' medical records, for catching cancers younger and at earlier stages than we used to. Her verdict on screening: "life saving."

The numbers behind the pink

Dr. T came prepared with statistics, and admitted some of them scared her:

  • About 350,000 women in the U.S. will be diagnosed this year, roughly 1,000 a day, or about one every two minutes.
  • About five women an hour will die of breast cancer.
  • Women of color are more likely to be diagnosed at more advanced stages, often because they aren't getting screened.
  • About 1 percent of breast cancers occur in men, more than 3,000 diagnoses a year. Men of color are disproportionately affected and also tend to be diagnosed later. If a man in your life notices symptoms, he should get checked.

She reminded me that screening isn't perfect and won't catch everything. But 30 minutes once a year could save your life, or the life of someone you love.

Don't let cost stop you

If you have insurance, Dr. T says your screening mammogram at the appropriate age is covered. If you don't, reach out anyway. There are low-cost and even no-cost options, and she says Louisville has been great about connecting people to care. If you have a family history or any symptoms, she says, don't delay.

Dr. T's goal is for all of us to start saying "I know someone who beat breast cancer" instead of "I know someone who had it." This month, make the appointment. Then call a friend and tell her to make hers.

Have a topic you'd like Dr. T and me to cover? Send us a note!