Education, awareness and access all may contribute to higher rates of breast cancer diagnoses in NoCo

Nov. 12—While the calendar has flipped the page on October and all the Halloween decorations and Breast Cancer Awareness pink ribbons have been packed away until next year, awareness and education around the disease continues.

Breast cancer education seems to be on patients' radar in northern Colorado, as the Centers for Disease Control and National Cancer Institute have reported Larimer County as having higher incidences of the disease compared to the rest of Colorado and U.S.

Per every 100,000 people in Larimer County, the studies showed 145.8 reported breast cancer cases, explained Dr. Molly Decker a breast and general surgeon with Banner Health. Douglas County inches a bit higher with 151.8 cases compared to the state with 130.4 cases and the U.S. at 128.1 cases.

"This might be attributed to a few factors. Counties with higher incidences may have higher awareness of health and the need for prevention and/or screening," Decker said in an email to the Greeley Tribune. "When you look at Colorado's geography —large distances, mountainous landscape —people on the Front Range may have better access to medical facilities including mammography and primary care compared to the eastern plains or the frontier areas."

"Distance to mammography centers is a huge factor for patients in deciding whether to get a mammogram."

While being one of the leaders in reported breast cancer cases isn't anything to celebrate, it does show that women in northern Colorado may be better in tune with their bodies when it comes to noticing abnormalities like lumps or bumps in their breasts.

Family Nurse Practitioner Erin Gronenthal is one northern Coloradoan that has contributed to the region's higher rate of reported breast cancer cases.

In 2020, Gronenthal was diagnosed with stage two triple-negative breast cancer. She was just 37 at the time with no history of breast cancer in her immediate family.

"I was literally watching TV in bed with my husband and my right breast had some itching so I want to go scratch it and I found the lump," Gronenthal explained. "I knew right away that that was not normal for me."

The next day, Gronenthal, who lives in Berthoud and works with Banner Health in Loveland, mentioned finding the lump to one of her co-workers.

"I told her I found this lump and it wasn't normal, but there's no way it could be cancer. She was like, 'you're getting it checked out'," Gronenthal said.

Gronenthal underwent a diagnostic mammogram and ultrasound, however, the mammogram did not pick up the lump due to her dense breast tissue.

"Whenever you find a lump you usually get a diagnostic mammogram and always an ultrasound," Gronenthal said. "So I the ultrasound found it and I had a biopsy."

The biopsy results returned with the frightening diagnosis of stage two triple-negative breast cancer.

Triple-negative breast cancer accounts for 10-15% of all breast cancers, according to the American Cancer Society. The term "triple-negative" means that the cancer cells have tested negative for having estrogen or progesterone receptors and they do not make any or too much of a protein called HER2.

This specific cancer tends to be more common in women younger than 40, who are Black or who have the breast cancer gene mutation BRCA1. Triple-negative breast cancer is also more aggressive, growing and spreading faster than other breast cancers. There are also fewer treatment options for patients with triple-negative breast cancer.

Due to the lack of breast cancer in Gronenthal's family history combined with her young age, Gronenthal opted for genetic testing to be done to see if there was a correlation with her genes and genetic history and the early onset of cancer.

"It was news to me, but I found out I had the BRCA2 mutation making me a high risk for breast, ovarian and other types of cancers," Gronenthal said. "I actually found out it was my grandpa, who has passed away, gave it to my mom. So, my mom has the BRCA2 mutation but no history of breast cancer."

Gronenthal's identical twin sister also carries the BRCA2 mutation. Both her mother and sister opted for mastectomies and hysterectomies as preventative measures against breast and other cancers.

"I took one for the team getting the cancer," Gronenthal quipped.

With the cancer being so aggressive, Gronenthal went through six months of chemotherapy, removal of her breasts, ovaries and uterus and did radiation and oral chemotherapy.

"At the time they took my breasts, there was still cancer left after the chemotherapy, so to reduce my risk of recurrence they put me on a year of oral type of chemotherapy," she explained. "Which I just finished this past summer."

The United States Preventive Services Task Force recommends that women age 50 to 74 years old and who are at average risk for breast cancers get a mammogram every two years. Women with a family history of breast cancer should talk with their health care provider to determine their risk and if they should be screened at an earlier age.

No matter your risk level, women should do breast self-exams each month a week after their period ends to identify any unusual lumps, bumps, changes in skin, irritation, pain or other abnormalities in their breasts and tissue.

Not sure how to do a self-exam on your breasts?

Check out this helpful step-by-step guide from For the Love of Cups at http://bit.ly/3hD8DlL.

Rather than hide what she went through, Gronenthal uses her diagnosis and medical journey with breast cancer to educate others about the BRCA genes, the importance of self-exams and mammograms and being familiar with your body.

"I would not be here if I was not in tune with my breasts," she said. "It was tough to go through, but now I can better treat my patients and educate them."

Below is a list of resources that provide information on breast cancer, screening guidelines and options as well as the BRCA1 and BRCA2 mutations.

* The Mayo Clinic — http://bit.ly/3WWgmv7

* Centers for Disease Control and Prevention —http://bit.ly/3WSF0wO

* American Cancer Society — http://bit.ly/3Ttn0WL

* Susan G. Komen Foundation — http://bit.ly/3fZKJQW

* Cancer.Net — http://bit.ly/3WZoOtB

* BreastCancer.Org — http://bit.ly/3Twi5Vg

* National Cancer Institute — http://bit.ly/3E2Sihw

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