Digging Deeper Into Breast Cancer Prevention and Screening with Dr. Damé Idossa
Breast cancer is among the top five causes of death in Minnesota Women. Of those, black women have a 40% higher mortality rate than white women when it comes to breast cancer. Closing this gap and understanding how we can improve outcomes for women with breast cancer is extremely important.
For Breast Cancer Awareness Month this October, Damé Idossa, MD, an assistant professor of medicine at the University of Minnesota Medical School and member of the Masonic Cancer, talks about health disparities within breast cancer, closing those gaps, and the importance of screening.
Q: Could you give us some background on growing up, your education, and what brought you back to Minnesota?
A: I was born in Ethiopia and immigrated to Minneapolis when I was 8 years old. I grew up in Richfield, Minnesota and then went to the University of Minnesota for undergrad where I majored in biology and physiology. I attended Yale University for medical school. After that, I came back to Minnesota and did internal medicine residency at the Mayo Clinic. I just completed my oncology fellowship training at UCSF in California and now I am back at the University of Minnesota working primarily in breast cancer.
Q: How did you know you wanted to work in medicine - specifically breast cancer?
A: Medicine was always a contender among a few other things that I was potentially interested in. I’ve always had an interest in the sciences and really enjoyed that aspect throughout my undergraduate training. I was involved in a pipeline program at the University of Minnesota called “Minnesota’s Future Doctors Program” which really exposed me to medicine and research, and also gave me the opportunity to imagine what a career in medicine would be like. After that program, I was confident that I would be pursuing a career in medicine.
As for oncology, I didn’t decide on that until I was in residency. I think sometimes when people think of oncology, they think it may be really sad or emotionally challenging, but that’s not always the case. I had the opportunity to see what the inpatient practice would be like, which at times can be challenging, but I also had the opportunity to work in the outpatient setting where patients were living for 10+ years, which was really gratifying to see. I was able to see the longitudinal relationships that oncologists can have with their patients and also the huge difference that the researchers and physicians were making in people’s lives. That was when I really decided on oncology.
My interest in breast cancer didn’t come until my fellowship program. I trained with some of the world’s leading breast oncologists, so that was a really driving force. I’ve always been interested in women’s health, and I think that breast cancer really encompasses that as well.
Q: Why did you choose to come back to the University of Minnesota?
A: I would say it’s for two reasons:
- One is family. All of my immediate family is in Minnesota and I wanted to be closer to them.
- Secondly, it was the community here in Minneapolis. I’m really interested in working with diverse and immigrant populations. One of my major research interests is within the realm of health equity and health disparities. For example, there are many issues within immigrant communities in terms of cancer screenings. It’s a community that needs a lot of support and there’s a lot of work to do in that space.
Additionally, I think you have to find your people wherever you go. Within each institution I’ve worked at I ask myself, “Are these the folks that I would work well with?” And as I was going through each interview process, that was a question I kept asking myself. The colleagues that I work closely with here in breast cancer are all fantastic.
Q: What comes to mind when you think about Breast Cancer Awareness Month
A: Breast cancer is a cancer that we, as researchers and physicians, have made a lot of headway in, in terms of survival rates. Most of our patients actually do really well long-term but if you look at the data a little bit closer that’s not the case for everyone. We don’t always highlight the disparities that exist within breast cancer outcomes. There are many different reasons as to why those disparities exist, and I don’t think it’s something that the general population thinks about. For example, when we look at breast cancer mortality, black women have a 40% higher mortality rate compared to white women. I think about those things quite a lot and many researchers are working towards figuring out how to close that gap.
Q: Would you say that preventative medicine, screenings, and general health maintenance are the most important factors in cancer prevention?
A: The issue with disparities is that you’re going to find a problem at different points in time. But yes, one issue is disparities within breast cancer screening in Minnesota. In other parts of the country, black women have very comparable breast cancer screening rates to white women, but their outcomes are still worse. There are also screening gaps between women who live in rural areas compared to urban areas. I think for our communities in Minnesota, we can focus on screening as one of the preventative measures we can take to reduce disparities. This not only means ensuring people have access to getting screening mammograms, but also that they can get time off work, have transportation, have childcare, etc. Ensuring that all of the social risks that people might have are addressed in order to allow them to actually engage in their care and stay up-to-date with their screenings is really important.
Q: Are there services available in the community that could help fill the gaps for people to more easily access screenings and other types of care?
A: One of the two organizations I’ve learned about recently that I think is doing really great work is the Breast Cancer Gaps Project. They really focus on the disparities I mentioned earlier in black women, and their whole aim is to increase screening rates in black women in Minnesota. The other group is Gilda’s Club. They do really great work and would be a helpful organization to be aware of. There are many other organizations that I am still learning about.
Q: What is happening at the University of Minnesota in either cancer research or care that excites you about being here?
A: From a research standpoint, we have many amazing clinicians and researchers who are doing really exciting work in breast cancer. We also have many clinical trials available at the University of Minnesota that provide patients with innovative treatment options for their cancer. One example of this is a trial called the I-SPY clinical trial, which is an adaptive randomized trial that allows us to test many different treatments for breast cancer and selects the ones that should work best for our patients based on the molecular types of their breast cancer. It is really a way to personalize treatment options and tailor the right treatment for each patient.
From a care standpoint, I love the ability to allow patients to see a specialist here at the University of Minnesota but get their care closer to home if they desire. For a lot of patients, it can be a huge barrier to get onsite, pay for parking, take time off work, and navigate the clinic. If you can still have access to a specialist at the University but get your infusions locally, that’s huge. That is something I have been really impressed with.
Q: What does it mean to you to be able to serve a diverse community as a physician of color? How would you describe the importance of representation in medicine?
A: I’ve certainly come full circle. I’m coming back to the place where I was initially introduced to medicine as a prospective career. Within oncology, less than 2% of physicians are black women. There aren’t very many of us, so to be able to be in a place where other students and trainees can see someone that looks like them as an oncologist is an honor. In addition, to have people in the community see physicians that look like them and can potentially speak their language, I think that is really huge. For the students and trainees, I want to ensure that the door stays open so that they can walk this same path if they desire. And for patients, I think it’s an opportunity to break barriers that exist for patients of color and build trust with them so that they can access the care they deserve, and hopefully end up having better outcomes. Thinking about the possibility of all of that is really exciting and I’m really grateful for the opportunity.
Q: How do you think younger women can be proactive in their own breast health as well as with the other women in their lives?
A: It’s now well known that cancer screening dramatically dropped during the initial COVID surge in March of 2020. After that, some populations never really recovered back to their baseline. There are many people who have missed or delayed their screening over the past few years. I think it’s very important for those who are 40 years old and above, to go and get screened. Depending on family history, some people may need to get screening earlier than that. For those who are younger than 40 and don’t have a family history of breast cancer, it’s always important to be mindful and recognize changes in their body. If they notice any new breast lumps, skin changes, or anything else that concerns them, they should get checked out. We unfortunately see breast cancer in young women, even when they don’t have a family history. So it’s important to stay vigilant and advocate for themselves.
About the Masonic Cancer Center, University of MinnesotaThe Masonic Cancer Center, University of Minnesota, is the Twin Cities’ only Comprehensive Cancer Center, designated ‘Outstanding’ by the National Cancer Institute. As Minnesota’s Cancer Center, we have served the entire state for more than 30 years. Our researchers, educators, and care providers have worked to discover the causes, prevention, detection, and treatment of cancer and cancer-related diseases. Learn more at cancer.umn.edu.
About the University of Minnesota Medical SchoolThe University of Minnesota Medical School is at the forefront of learning and discovery, transforming medical care and educating the next generation of physicians. Our graduates and faculty produce high-impact biomedical research and advance the practice of medicine. We acknowledge that the U of M Medical School, both the Twin Cities campus and Duluth campus, is located on traditional, ancestral and contemporary lands of the Dakota and the Ojibwe, and scores of other Indigenous people, and we affirm our commitment to tribal communities and their sovereignty as we seek to improve and strengthen our relations with tribal nations. For more information about the U of M Medical School, please visit med.umn.edu.