Women: Take Time for You
Take Steps to Prevent Breast Cancer.
Breast Cancer Awareness Month is a platform physicians and communities alike take to heart, and at the MemorialCare Breast Center, we're committed to helping patients maintain optimal breast health. It's especially easy for women to get lost within the busy roles of mom, business executive and/or caregiver, meaning they oftentimes neglect their health.
Therefore, while breast care should be a year-round concern, there is no better time than October to come together as a community to educate women on breast cancer prevention and detection.
Know the Facts
The facts are that for women today, one in eight will be diagnosed with breast cancer, whereas in the 1970s, the lifetime risk of being diagnosed with breast cancer was under 10 percent†. The National Cancer Institute has estimated that in 2010, there have been 207,090 new diagnosed cases among women and nearly 40,000 deaths.
Therefore, it's not a surprise that as a physician, I've learned that cancer is arguably one of the most-feared words in the human language.
While we have yet to pinpoint a specific root cause of cancer, we know that environmental and nutritional factors – things we're exposed to over time – as well as family history have a direct impact. In addition, there has been linkage between a higher risk of breast cancer for women having children later in life, or not having children at all.
Just as each woman feels the responsibility to fill the diverse roles in life, it's her responsibility to become educated on the facts, risk factors and screenings needed throughout each decade and phase of life.
In recent years, digital mammography has emerged from the conventional film mammography developed in the 1960s. While it is still being adopted in breast cancers throughout the country, those that offer this technology provide women with less radiation exposure and better detection rates.
With digital mammography, images are directly captured by a computer rather than the traditional film. On the computer, these images can be enlarged and manipulated, and integrated with computer-aided detection software programs, which mark potential areas of concern. As a result, abnormalities are more noticeable, especially for younger women who tend to have denser breast tissue, and breast cancer can be detected at a much earlier stage.
Today, digital mammography can only be performed at facilities certified to use this equipment, so women need to research their hospital or breast center ahead of time.
Recently, the U.S. Preventive Services Task Force stated that women only need mammograms starting at the age of 50, not 40, and every two years, rather than every year. While these guidelines did not apply to high-risk women, they understandably raised a lot of concern in the industry, causing an outcry from oncologists and confusion among women.
Despite these reports, as a physician with years of experience, I still recommend annual mammograms beginning at age 40. Mammograms are one of the most avoided tests among women, yet it is imperative women schedule these tests in their 40s even if they don't have any known risk factors. At this age, we begin to look for changes in the breast from year to year, which could indicate the onset of breast cancer. The average age breast cancer develops among women is 56, making the 50's age range imperative for women to continue regular mammograms and screenings.
Whether choosing digital or film, how do women know when they should begin annual mammograms? Guidelines typically state women should begin at the age of 40, however, it often comes down to risk factors such as family history.
Nowadays, women with a family history of breast cancer have the option of genetic testing, where doctors can determine whether altered genes that carry a higher risk of breast cancer are passed through one's family. These altered genes that most commonly increase a women's risk of breast cancer are known as BRCA1 and BRCA2, or Breast Cancer Gene 1 and Breast Cancer Gene 2.
Most centers that specialize in genetic testing offer counseling services, where women can discuss their family history of cancer, learn more about how genes are inherited, and discuss whether the benefits of genetic testing outweigh the risks. It's important to note that genetic testing is not for everyone. Women must be prepared to accept the results and treatment option choices.
Screening for High-Risk Women
Women carrying the BRCA1 or BRCA2 gene mutation, or who have a strong family history of breast cancer, should begin screenings at age 25 with an annual mammogram and annual breast MRI. These women should still have yearly breast checks at their gynecological exams, and conduct self exams on a regular basis.
Once women enter their 30s, it's critical that they continue breast checks at annual gynecological exams, with at-risk women getting mammograms per their doctor's specific recommendations.
In closing, women need to be empowered to take control of their health. They need to understand the statistics, their personal and family risk factors, and their choices when it comes to genetic testing or the use of advanced technologies like digital mammography.