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Listen to the Mammography / Breast Cancer Healthy Minute
Fighting Breast Cancer with Education
What You Need to Know About Breast Cancer
One hundred eighty two thousand four hundred and sixty. That’s the number of sisters, mothers and daughters who will be diagnosed with invasive breast cancer this year. The sooner breast cancer is detected, the sooner treatment options can be discussed and the better chance of recovery. There have been great advances in the early diagnosis and treatment of breast cancer. These advances give patients greater options in their breast health.
Breast cancer is a malignant tumor (cancer) that starts from cells of the breast. It is found mostly in women, although men too can get the disease (the risk of men getting this disease in their lifetime is 1 in 1,000 according to the American Cancer Society).
Breast cancer is the most common cancer among women in the United States. It is the second leading cause of cancer death in women. However, breast cancer death rates are going down (they are now about 1 in 35).
It is important to know the symptoms of breast cancer. When the disease is discovered early, you have a better chance for a cure.
The most common sign of breast cancer is a lump, or mass. A mass that is painless, hard and that has uneven edges is more likely to be cancer. Other signs and symptoms include:
- A clear or bloody discharge from the nipple
- Skin irritation or dimpling
- Swelling of the breast
- Nipple pain or the nipple turning inward
- Redness, scaliness, or thickening of the nipple or breast skin
- A lump in the underarm area
There are other conditions that can cause changes in your breast, including benign changes such as fibrocystic breast disease, cysts, infection, or injury. Any changes should be discussed with your doctor.
The fight against breast cancer starts with you. You can reduce your risk of getting breast cancer by keeping a healthy weight, exercising and not smoking. Know your risk factors. Some risk factors, such as your age, sex and family history, can't be changed, whereas others, including weight, smoking and a poor diet, are under your control. Having a risk factor, or even several, does not mean that you will get the disease.
Risk factors that can make you more susceptible to breast cancer
Age: Your chances of developing breast cancer increases with age. About 2 out of 3 women with invasive breast cancer are age 55 or older when the cancer is found.
Family History: If you have a female or male relative with breast cancer, your risk of getting the disease increases. If you have a first degree relative, a mother, sister or daughter, diagnosed with breast cancer before age 50, your chances of getting breast cancer doubles.
Genetic Predisposition: About 5-10% of breast cancer cases are thought to be hereditary, resulting from gene mutations, especially those of BRCA1 and BRCA2. Normally, these genes make proteins that help prevent cancer. When these genes are mutated, you have a higher chance of developing cancer.
Personal History: If you have had breast cancer in one breast before, you have an increased risk of developing cancer in the other breast.
Radiation exposure: If you had radiation therapy for another type of cancer as a child or young adult to your chest, you have a greater risk of developing breast cancer. This risk increases even more if the radiation was given at the time of breast development.
Excess weight: Being overweight or obese has been found to increase breast cancer risk, especially for women after menopause. The connection between weight and breast cancer risk is complex. The risk appears to be increased for women who gained weight as an adult but may not be increased among those who have been overweight since childhood. Also, excess fat in the waist area may affect risk more than the same amount of fat in the hips and thighs. Researchers believe that fat cells in various parts of the body have subtle differences that may explain this.
Race: Caucasian women are slightly more likely to develop breast cancer than are African-American women. African-American women are more likely to die of this cancer. At least part of this seems to be because African-American women tend to have more aggressive tumors, although why this is the case is not known.
Menstrual Periods: Women who started menstruating at an early age (before age 12) and/or went through menopause at a later age (after age 55) have a slightly higher risk of breast cancer. This may be related to the fact that they’ve had more menstrual cycles that lead to a higher lifetime exposure to the hormones estrogen and progesterone.
Not having children, or having them later in life: Women who have had no children or who had their first child after age 30 have a slightly higher breast cancer risk. Having many pregnancies and becoming pregnant at an early age reduces breast cancer risk. Pregnancy reduces a woman's number of lifetime menstrual cycles, which may be the reason for this effect.
Recent oral contraceptive use: Studies have found that women using oral contraceptives, or birth control pills, have a slightly greater risk of breast cancer than women who have never used them. However, this risk seems to decline once their use is stopped. Women who stopped using oral contraceptives more than 10 years ago do not appear to have any increased breast cancer risk.
Hormone Therapy: treating menopausal symptoms with the combination of estrogen and progesterone for 4 or more years increases your chance of developing breast cancer.
Smoking: The relationship between smoking (also secondhand smoke) and breast cancer risk isn’t entirely known. Some studies show no link between them. Other studies suggest there is a connection between smoking and breast cancer. There are clear health benefits, however, to quitting smoking.
Alcohol Use: Breast cancer risk increases with the amount of alcohol consumed daily. Women who have more than 2 drinks daily have about 1 ½ times the risk of women who do not drink. According to the American Cancer Society, women should limit their alcohol consumption to no more than 1 drink daily.
Dense breast tissue: Women with denser breast tissue (as seen on a mammogram) have more glandular tissue and less fatty tissue, and have a higher risk of breast cancer. Unfortunately, dense breast tissue can also make it harder for doctors to spot problems on mammograms.
Benign breast conditions: Women diagnosed with certain benign breast conditions may have an increased risk of breast cancer.
Early Screening
Early screening is the key to finding breast cancer in its early, treatable stages. Depending on your age and risk factors, screening may include breast self-examination, clinical breast exam, mammography or other tests.
- Breast Self-Examination:
Beginning at age 20, women can examine their breasts for changes. Get familiar with the look and feel of your breasts in order to detect early signs of cancer if they develop.
- Clinical Breast Exam:
Women in their 20s and 30s should have clinical breast exams by a health expert at least every 3 years. During this exam, the doctor examines your breasts for lumps or changes and will also check for enlarged lymph nodes in the armpit area.
- Mammography:
All women age 40 and over should have annual mammograms. A mammogram uses a series of x-rays images of your breast tissue. This technology is able to detect tumors possibly before they are palpable.
There are 2 types of mammograms:
- Screening mammograms — These are performed every year to detect changes in breast tissue
- Diagnostic mammograms — If a breast change is detected by you or your doctor, they may recommend a diagnostic mammogram to evaluate the area of concern more closely.
Although not fail-proof, mammography is the most reliable screening tool for women.
During a mammogram, your breasts are compressed while radiologist technician takes the x-rays. The entire procedure usually takes less than 30 minutes. If you have tender breasts, schedule the mammogram for after your menstrual period. Avoiding caffeine for 2 days before the test can help with breast tenderness.
Many imaging centers now use Mammopad®, a soft foam cushion placed on the surface of the compression plates of the mammography, helping to reduce the discomfort experienced by some women.
A recent enhancement to the traditional mammography includes digital mammography. This is the combination of conventional x-rays and computers, much like today’s digital cameras. With digital mammography, the image is immediately available. This technology is helpful in identifying subtle differences in breast tissue by altering the contrast and darkness of the image. This is particularly useful for women with dense breasts.
To prepare for a mammogram, the American Cancer Society recommends you:
- Do not wear deodorant, talcum powder or lotion under your arms or on your breasts on the day of the exam. These can appear on the mammogram as calcium spots.
- Describe any breast symptoms or problems to the technologist performing the exam.
- If possible, obtain prior mammograms and make them available to the radiologist at the time of the current exam.
- Ask when your results will be available; do not assume the results are normal if you do not hear from your doctor or the mammography facility.
A MRI can be used as an additional tool to study the breast. The MRI uses a magnet and radio waves to take pictures of the interior of your breast. Although not used for routine screening, the MRI can detect tumors that are too small to detect through physical exams or traditional mammography.
Women at high risk (greater than 20% lifetime risk) should get an MRI and a mammogram every year. Women at moderately increased risk (15% to 20% lifetime risk) should talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram. Yearly MRI screening is not recommended for women whose lifetime risk of breast cancer is less than 15%.
Recent recommendations also suggest that women with newly diagnosed breast cancer have an MRI to detect tumors that were possibly missed.
Breast Ultrasounds can also be a useful tool in evaluating an abnormality found by mammography or clinical exam. Ultrasound uses sound waves to produce an image. This is helpful in determining if a mass is a cyst of solid tissue (more likely to be cancerous).
Another test that is used in diagnosing breast cancer is Computer-aided detection (CAD). In traditional mammography, your X-rays are reviewed by a radiologist, whose skill and experience play a large part in determining the accuracy of the test results. In CAD, a computer scans your mammogram after a radiologist has reviewed it. CAD identifies highly suspicious areas on the mammogram, allowing the radiologist to focus on specific spots, but many of these areas may later prove to be normal. Still, using mammography and CAD together may increase the cancer detection rate.
Diagnostic procedures help to further characterize breast abnormalities found by exam, mammogram or MRI. These tests help your doctor determine the need for a biopsy and also may be used to help guide a biopsy.
A biopsy is used to tell if cancer is present. A small sample of tissue is removed for analysis in the lab. This helps determine what treatment is necessary. There are many types of biopsies that can be discussed with your doctor.
Once evaluated, cancer is staged using the numbers 0 through IV. Stage 0 cancers are also called noninvasive, or in situ (in one place), cancers. Although they don't have the ability to invade normal breast tissue or spread to other parts of your body, it's important to have them removed because they eventually can become invasive cancers.
Stage I to IV cancers are invasive tumors that have the ability to invade normal breast tissue or spread to other areas. A stage I cancer is small and well localized and has a high cure rate. But the higher the stage number, the lower the chances of cure. By stage IV, the cancer has spread beyond your breast to other organs, such as your bones, lungs or liver. Although it's not possible to cure cancer at this stage, it may still respond well to various treatments, which could effectively shrink and control the cancer for an extended period of time.
Hearing the words “You have cancer” is life-altering. However, technological advances have improved treatment options so the chance of recovery is higher than ever before. Treatments exist for every stage and type of breast cancer. Most women will have surgery and an additional therapy, such as radiation, chemotherapy, or hormone therapy. Experimental treatments are also available at certain cancer centers.
It’s important to speak with your doctor about treatment options available to determine what is right or you. The more information you have, the more prepared you are to make the necessary decisions. It’s also important to seek support from a counselor to deal with the emotional consequences of cancer if necessary.
Women at high risk of breast cancer should talk with their doctor about the best approach for them, including earlier screening. Take control of your health and be smart about breast health. Know your risk, get the appropriate screenings, and talk with your doctor if you suspect a problem.
If you need to schedule a mammogram, visit ImageCare to find a location near you.
Listen to the Mammography / Breast Cancer Healthy Minute
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