BAY AREA TO INCREASE SCREENING TO REDUCE BREAST CANCER DEATHS.

Byline: Gregory Lewis San Francisco Examiner 

In a stepped-up effort to detect breast cancer earlier among San Francisco women, who have one of the highest rates of breast cancer in the world, the city will provide mammograms, follow-up treatment and counseling to more women.

The city's public health director, Dr. Sandra Hernandez, hopes the Breast Cancer Early Detection Initiative will target women who haven't received preventive treatment for the disease.

"There are a lot of ethnic communities where we have to find out what their perceptions of cancer are and then we must make a targeted effort to get them screened and get them into the system," Hernandez said Tuesday in launching the effort.

Such an effort is important not only for improving women's health - it may also help to determine why the Bay Area has one of the highest reported rates of breast cancer in the world.

"Every day, breast cancer strikes 12 women in the Bay Area, and kills three women," said Brenda Brenner, executive director of Breast Cancer Action.

On Tuesday, Mayor Willie Brown Jr., Supervisor Carole Migden and Hernandez announced an effort to improve the citywide breast cancer detection program in place at San Francisco General Hospital.

Health department staffers will visit city and neighborhood clinics, reviewing charts and counseling women about breast cancer, Hernandez said.

"It will be like a citywide case finding," she said. "We'll find women we wouldn't otherwise see. We'll be able to get them a mammography and refer them to a physician who will do follow-up."

Hernandez and Migden expressed concern about women who get a mammogram that shows something abnormal, but never receive any further advice or treatment.

"Early detection saves lives," Migden said. "In many cases there's been no follow care. . . . It's important to establish clinics where all women in San Francisco can go . . . and when there's an abnormal mammogram it will be reviewed."

Bayview-Hunters Point resident Francine Carter called the effort "a start."

"Anything is better than nothing. Bayview-Hunters Point is a high-risk area. Finally someone is paying attention," Carter said.

According to a study by the Public Health Department, the Bayview-Hunters Point District has higher than normal rates of breast and cervical cancers.

African-American women younger than 50 account for much of the higher incidence of breast cancer; their rate of getting the disease is double that of San Francisco as a whole.

According to a U.S. Department of Health and Human Services study, from 1988-1992, 109 women for every 100,000 in the United States were diagnosed with breast cancer. The rate was 107 for the state; 105 for San Francisco County.

But African-American and white women in San Francisco had rates of incidence that were significantly higher than state and national rates for their comparable groups.

At Tuesday's press conference, cancer treatment activist Gracia Buffleben, who has battled breast cancer herself for the past decade, was presented the first Elenore Pred Award. Pred was co-founder of the San Francisco advocacy group Breast Cancer Action. She died in 1991.

Migden began urging the health department last year to "enhance its efforts to prevent late-stage diagnosis of breast cancer and to reach targeted populations who were not receiving adequate mammograms and detection exams."

Hernandez said an epidemiologist would study different racial groups and focus on specific neighborhoods to determine how breast cancer manifests itself in San Francisco.