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North and Central Texas women get breast cancer at higher rate than other regions of state

03/16/2010 11:33 PM

03/17/2010 1:21 PM

Women in North and Central Texas get breast cancer at a higher rate than all other regions in the state.

Experts don't know exactly why.

"We think it's a combination of a lot of different factors," said Dr. Keith Argenbright, medical director for UT Southwestern Moncrief Cancer Resources.

North Texas has more breast cancer per 100,000 women than any area of the state, he said. In Tarrant and its surrounding counties, the rate for breast cancer is 120 cases per 100,000 women compared to the state rate of 114.3 cases, according to the Texas Cancer Registry. It's equally as high in the Central Texas region, which includes Travis County and 29 others.

One reason the region's rate is high is that Tarrant County is doing a good job catching breast cancer at an early, treatable stage, said Betty Nethery, past president of the Susan G. Komen for the Cure Tarrant County board.

Making sure women get screened, no matter what their income level or where they live, is the way to ensure that breast cancer is diagnosed.

And UT Southwestern Moncrief Cancer Resources has been awarded a nearly $1 million grant from the Cancer Prevention and Research Institute of Texas to do just that.

The two years of funding will allow Moncrief Cancer Resources to expand its Breast Screening and Patient Navigation program from Tarrant County into Denton, Wise, Parker, Hood and Johnson counties. "The purpose of the grant is to take what we're doing in Tarrant County that we have proven works, and do it again in outlying counties," Argenbright said.

But for uninsured or underinsured women in rural North Texas communities, getting a mammogram can be challenging. Facilities are limited, with only two counties having one facility for breast screening and diagnostic mammography. In Denton County, the number of women who are eligible to be screened but have not had a mammogram in the past two years is estimated to be between 25,171 and 38,724.

Moncrief Cancer Resources has proven that screening can make a difference to medically disadvantaged women in Tarrant County. Between 2008 and 2009, the breast-screening program used its three mobile digital mammography units to perform 3,527 screening mammograms and detect 23 cancers.

While its rate of detection is higher, Tarrant County's mortality rate for breast cancer -- 22.6 per 100,000 -- shows that the area is doing a good job catching the disease early, Nethery said. It's slightly lower than the state rate of 22.8.

Moncrief Cancer Resources plans to decrease or remove the financial and geographic barriers that women in rural counties face by providing mammograms at clinics and through mobile units.

"We also want to work with local doctors and hospitals in those counties to utilize some of their resources in this fight as well," Argenbright said.

Culturally appropriate educational services will also be put in place in an effort to encourage women who are hesitant to get screened, he said.

"The main barriers to breast cancer screening are fear and finance," she said. "Moncrief is breaking down these barriers through its educational efforts."

Although screening guidelines have been called into question recently, UT Southwestern Moncrief Cancer Resources will stick with screening beginning at age 40, Argenbright said.

"The results we have gotten so far in Tarrant County show that about half of the women we find with breast cancer are less than 50," he said.

In an ideal world, women would make the decision about when to have a mammogram with their physician, but that's not always an option, Argenbright said. Uninsured or underinsured women don't always see a physician on a routine basis and for that reason the more conservative recommendation is being followed, he said.

In Texas, fewer women over 40 have had mammograms in the past two years than the national average, according to the Texas Medical Association. A report from the association found that 71 percent of Texas women 40 and older got a mammogram compared with 76.6 percent nationwide.

The breast-screening program has made it easier for more women to get mammograms, and, as a result, 79 percent of cancers have been found at an early stage when the cure rate is greater than 90 percent, Argenbright said.

JAN JARVIS, 817-390-7664

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