Many young women state that their biggest health fear when growing older is breast cancer. On the flip side, many women don’t worry about breast cancer because it doesn’t run in their families. This false sense of security can be a costly mistake if it keeps you from having preventative testing.
Let’s explore breast cancer risk factors, prevention, diagnosis and treatment.
Consider the following breast cancer facts:
You can’t completely prevent breast cancer—everyone is at risk. Great strides have been made in breast cancer awareness in recent years, with more women aware of the symptoms and utilizing self-exam and diagnostic techniques regularly.
Understanding your risk
You can control some risks for developing breast cancer. Unfortunately, with breast cancer, the risks you can’t control outweigh the ones you can. For these reasons, early detection is important. The following are major risk factors for breast cancer:
Risk factors for men include age (the average age for breast cancer in men is about 67), obesity (obese men have higher levels of estrogens in their body), testicular and liver disease, and a disease called Kleinfelter’s syndrome, which occurs in men who are born with two or more “x” chromosomes. Exposure to high levels of radiation also increases men’s risk.
Scientists have found that women with genetic mutations (random structural changes) to genes BRCA1 and BRCA2 (short for Breast Cancer 1 and Breast Cancer 2) have up to an 85 percent chance of developing breast cancer in their lifetime. Less than 10 percent of breast cancer cases are related to inheritable genes, however, if you do have a strong family history, your doctor may want you to have earlier or more frequent testing done.
Playing your part in prevention
“Know thy breasts” should be the defining statement for early detection of breast cancer. Breast cancer prevention starts with regular breast self-exams, beginning when you’re in your 20s. Using a step-by-step approach on a specific schedule, women can be aware of how their breasts normally look and feel.
Monthly self-exams provide you with a baseline; if anything changes from month to month, you’re the first to know. Report any breast changes to a health professional as soon as they’re discovered. Remember that a breast change doesn’t mean you have cancer!
The best time for a woman to examine her breasts is one week after her period is over, when her breasts aren’t tender or swollen, so she can feel any abnormalities or lumps that may be present. This examination is no small task at times; some women have very lumpy breasts and the lumps may change from month to month.
Women who are pregnant or breastfeeding should still keep examining their breasts regularly, even though the breasts may be tender. Women with breast implants should ask their surgeon to help them differentiate between breast tissue and the implant. To ensure proper technique, women should review their self-breast exam (SBE) process with their healthcare professional during their clinical breast exam.
Clinical breast exams should be done at every yearly gynecologic exam. At age 40, women need to have the first of their recommended annual mammograms as well as yearly breast exams, unless they had an abnormal breast exam or there’s a strong family history of breast cancer. Mammograms are currently the best and most reliable screening method, although it may take as many as six to ten years for breast cancer tumors to be detected by mammography. Your doctor may recommend an earlier screening if you have a personal or family history with breast cancer.
Sometimes ultrasound is used and is good for distinguishing whether a detected lump is a cyst (likely to be benign) or a solid mass (which could indicate a tumor). This technique is good to use in women with breast implants and dense breasts because a mammogram sometimes has difficulties “seeing” through dense tissue or implants. Ultrasound is also a great method for guiding physicians to do needle biopsies of suspicious lumps.
In 2007, the American Cancer Society recommended that women at high risk such as a previous history of breast cancer or a strong family history for breast cancer should have a magnetic resonance imaging (MRI) scan in addition to their mammograms. MRIs are more sensitive, picking up more spots than a mammogram, and may result in more false positive results. The two tests together give better data to evaluate a woman for breast cancer. If your doctor detects any abnormalities, he may schedule a follow-up biopsy or some other doctor-recommended procedure.
Recognizing the symptoms
When feeling for a lump in a breast, keep in mind the following things:
The technique recommended for self-breast exams has changed. There’s evidence that the woman’s position (lying down), area felt, pattern of coverage of the breast, and use of different amounts of pressure increase the sensitivity of the self-exam.
To perform a SBE, use these steps:
When you lie on your back, your breast tissue spreads more evenly and thinly over your chest. This position makes feeling for lumps or abnormalities easier.
You should circle the tissue three times and use varying levels of pressure before moving on to the next area.
Use enough pressure to feel all the breast tissue, but don’t cause yourself pain.
Use this pattern to help:
This up-and-down pattern is the most effective method for not missing any tissue.
The act of pressing down on your hips contracts the muscles in your chest. This makes any changes in your breast more apparent.
This completes your monthly exam. Report any lumps or abnormalities to your doctor.
Following up on a lump
Most of the lumps that you can feel are benign (not cancer); most often the first sign of breast cancer is abnormalities found on a mammogram when it can’t be felt on SBEs or by a medical professional. In fact, the American Academy of Family Physicians indicates as many as 90 percent of breast lumps are benign. Have any lumps or changes evaluated by your doctor.
After you find a lump in your breast, here’s what happens during a typical physician evaluation:
If the physician workup reveals any suspicious lumps you may be scheduled for one of the following procedures:
If your lump is breast cancer, the earlier you can begin treatment, the better your survival rate.
Treating breast cancer and considering the prospects
Treatment options for breast cancer include surgery, chemotherapy, hormone therapy, and radiation. The five-year survival rate for localized breast cancer is 98 percent. Unfortunately, advanced metastatic cancer has a higher mortality rate. If the cancer has spread regionally this survival rate drops to 81 percent and those with distant metastases have a 26 percent five-year survival rate. After the five-year mark, the overall survival rate drops to 80 percent.
*Agin, Brent, and Sharon Perkins. Healthy Aging for Dummies. Hoboken, NJ: Wiley Pub., 2008. Print.
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