October is Breast Cancer Awareness Month, a great opportunity to remind ourselves and our loved ones of the importance of early detection through breast cancer screenings and the steps women can take to reduce their risk for this disease.
Breast cancer is, unfortunately, quite common. One out of eight women will be diagnosed with breast cancer at some point. Nearly 4 million American women are currently living with the illness.
Nonetheless, there are plenty of reasons to be optimistic. An intense focus on breast cancer awareness over the last few decades had produced positive results:
- More women are getting screened regularly for breast cancer. That means cancers are detected earlier, when treatment is more likely to be successful.
- Treatment has advanced, making it possible for more women to successfully overcome breast cancer.
- Advances in the understanding of human genetics have made it possible to more accurately predict the likelihood of breast cancer for some women.
“Breast cancer is a tough opponent, but we are steadily gaining ground on this disease,” says Dr. Andrea Palmer, an obstetrician and gynecologist with offices in Fort Worth and Willow Park. “Regular screenings help us catch breast cancer early and better treatment options mean more women are able to recover and live healthy, long lives.
At Privia Medical Group North Texas (PMGNTX), we are committed to doing our part to increase awareness of breast cancer and the importance of screening and early detection. Our primary care providers (PCPs) ensure patients get the necessary screenings at the appropriate times. And for those who are affected by breast cancer, Privia’s highly-regarded breast surgical oncology specialists are there to provide expert treatment.
Breast Cancer Data Shows Good News
Breast cancer is the second-most deadly cancer to affect women, second only to lung cancer. While it is possible for breast cancer to also affect men, it’s very rare; only 1% of breast cancer cases are in men.
According to the U.S. Centers for Disease Control and Prevention (CDC), every year in the United States there are roughly:
- 240,000 new female breast cancer cases
- 42,000 breast cancer deaths
While those are big numbers, this data offers hope and encouragement. Most importantly, the percentage of women dying from breast cancer continues to decline. Consider:
- While breast cancer makes up 15.5% of all new cancer cases, it is responsible for just 6.9% of all cancer deaths
- The 5-year survival rate – that is, women who are still alive 5 years after their breast cancer diagnosis – stands at 91.2% (for 2014-2020). In the 1970s, the five-year survival rate was only about 75%. This is tremendous progress!
Early Detection is the Key
“We have a good chance of beating breast cancer if we catch it early,” explains Dr. Hina Virani Khan, an OB/GYN in Frisco. “This is why regular breast cancer screening is so important.”
Breast cancer detection is accomplished through a three-pronged strategy:
- Clinical breast exams
- Mammograms (or other imaging)
- Breast self-awareness
These are the basic guidelines for breast cancer screenings for most women, although your PCP may recommend a different schedule based on your health history:
- Women ages 25-39 should have a clinical breast exam every 1-3 years.
- Women ages 40 and older should have a clinical breast exam every year.
- Women ages 40 and older who have a normal risk of breast cancer should have a mammogram every year or every other year.
- Screening should continue until at least age 75.
- All women should conduct breast self-awareness.
So, what does all that mean?
Clinical Breast Exam
A clinical breast exam is a physical examination at your PCP’s office. The exam can be conducted with the patient lying down or sitting up. Your PCP examines the breasts for any abnormalities or changes, such as a lump or changes to the skin. Your doctor may also feel for any changes under your arms.
Mammogram
The mammogram, an x-ray image of the breast, is usually the most effective way to screen for breast cancer. Because treatment is most effective when the cancer is in its early stages, periodic mammograms increase the odds of successful treatment.
In some cases, a mammogram may be inconclusive, in which case the physician may order an additional diagnostic imaging exam, such as a 3-D mammogram, an ultrasound or an MRI to make a better assessment.
Women who have dense breasts – those with more fibrous and glandular tissue compared with fatty tissue – may be more likely to need additional diagnostic imaging. That’s because dense breast tissue may conceal tumors on a mammogram.
Breast Self-Awareness
Finally, a key component of early detection is breast self-awareness. The goal of breast self-awareness is for a woman to recognize any changes in the appearance or feel of her breasts. A significant percentage of breast cancers are initially detected this way – about half for women age 50 and older and more than 70% for women younger than 50. Breast self-awareness is recommended for women of all ages.
A breast lump does not necessarily mean cancer. Many women have lumps in their breasts that are not cancerous and not indicative of future cancer risk. For example, cysts and fibrocystic breast condition are two common causes of non-cancerous lumps.
“The purpose of breast self-awareness is for women to be able to recognize any changes in the size, shape, feel or appearance of their breasts,” explains Dr. Alicia Larsen, an OB/GYN in Fort Worth. “If you notice a change, make an appointment with your physician as soon as possible. It may be nothing to worry about, but it’s important to get it checked out.”
Breast Cancer Risk Factors
Many breast cancer risk factors are outside anyone’s control. For example, a major risk factor is getting older – the greatest incidence of breast cancer is in women over 50. Remember, just because you have one or more risk factors also does not mean you will get breast cancer. At the same time, it is possible to get breast cancer without having any known risk factors.
In addition to age, risk factors associated with breast cancer include:
- Family history: A woman who has a history of breast or ovarian cancer in her family, especially a first-degree relative such as a mother, sister or daughter who has had either cancer, is at elevated risk.
- Genetic mutations: Inherited gene mutations, such as BCRA1 and BCRA2 – known as the breast cancer genes – increase risk. Read our previous article about genetic testing for certain cancer markers.
- Early menstruation/late menopause: Women whose periods began before age 12 or who begin menopause after age 55 are at somewhat higher risk of breast cancer. In both cases, the woman is exposed to estrogen hormones for a longer period, increasing risk.
- Late pregnancy or never having been pregnant: Becoming pregnant for the first time after age 35 or never having a full-term pregnancy can increase risk.
- Dense breasts: Women with denser breasts are at elevated risk.
- Race: Black and Pacific Islander women are at greater risk of breast cancer.
Ways You Can Reduce Risk
While the risk factors above are mostly beyond one’s control, there are several things women can do to reduce their overall risk for breast cancer, including:
- Increase physical activity: A sedentary lifestyle increases the risk of breast cancer. Getting more physical activity can reduce risk.
- Lose weight: Women who are obese or overweight have an increased risk. Getting more physical activity and making improvements to diet can help reduce risk.
- Be careful with hormones: Taking hormones to replace estrogen and progesterone during menopause may increase breast cancer risk. Your physician can help advise you on the best course of action when considering hormone replacement therapy.
- Reduce alcohol consumption: Drinking too much alcohol increases the risk of several types of cancer, including breast cancer. Women who drink alcohol should have no more than one alcoholic beverage per day. If you have trouble cutting back on alcohol, this is something you should discuss with your PCP.
- Be careful with oral contraceptives: Some types of birth control pills may contribute to breast cancer risk. Talk to your PCP about the best contraceptive options to minimize your risk.
- Breastfeed: Women who nurse their babies have been shown to have a lower risk of breast cancer.
- Don’t smoke or vape: Smoking cigarettes is a known cause of many types of cancer, as well as heart disease. Vaping is not a safe alternative. If you smoke, talk to your health care provider to get help quitting.
Symptoms of Breast Cancer
Keep in mind that breast cancer often produces no noticeable symptoms initially – that’s why breast self-awareness, clinical breast exams and mammography are so important to catch the disease early.
When breast cancer becomes symptomatic, those symptoms may include:
- A new lump in the breast or armpit area
- Pain in any part of the breast
- Thickening or swelling of part of the breast
- Irritation or dimpling of breast skin
- Redness or flaky skin in the nipple area of the breast
- Pain in the nipple area
- Nipple discharge other than breast milk, including blood
- Any change in the breast’s size or shape
Having one or more of these symptoms does not automatically mean there is cancer; there could be another cause. However, you want to have it checked out by your doctor as soon as possible.
Diagnosis & Treatment
If a mammogram indicates an abnormality that may be cancerous, the patient will be referred to a breast specialist or surgeon. Additional imaging tests, such as an MRI or ultrasound may be conducted, and a biopsy may be performed to take a sample of tissue or fluid from the breast to test it for cancer.
In breast-conserving surgery, the cancerous tumor and surrounding tissue are removed from the breast. In other cases, the entire breast must be removed, a procedure known as a total mastectomy. Finally, in a modified radical mastectomy, the breast is removed, as well as some of the lymph nodes under the arm and lining of the chest muscles. In the event of a mastectomy, reconstructive surgery is sometimes performed at the same time. In other cases, breast reconstruction may take place later.
Additional breast cancer treatments include hormonal therapy, which blocks the cancer cells from getting the hormones they need to grow and spread. This treatment may be effective if the patient has one or more breast cancer receptors: estrogen, progesterone and HER2. Breast cancer in which none of these receptors are present is known as triple-negative breast cancer. Surgery and chemotherapy are the most effective ways to combat triple-negative breast cancer. Finally, biological therapy helps the body’s immune system fight cancer cells and cope with side effects from chemotherapy and radiation treatment.
While chemotherapy has been shown to be an effective breast cancer treatment, it is also very difficult on the patient. The common side effects of nausea, hair loss and extreme fatigue are tough physically and emotionally, making the continuous support of family and friends especially important.
PMGNTX has two highly respected, Fort Worth-based breast surgical oncologists on its team, Dr. Joseph Heyne and Dr. Anita Chow. Both are routinely recognized by their peers as being some of the best in their field.
Together, We Can Beat Breast Cancer
Regular screenings and early detection are the keys to beating breast cancer.
“By keeping up with regular screenings, you give yourself the best chance to overcome breast cancer by catching it early,” says Dr. Emily Maas, an OB/GYN in Fort Worth.
“Without question, a breast cancer diagnosis is scary – but with the support of your doctors, family and friends, you have a great opportunity to successfully fight this disease,” says Dr. Jamie Obst, a Fort Worth OB/GYN. “You won’t have to face it alone, and working together, we can continue to turn the tide against breast cancer.”
This October, take a few minutes to check if you are up to date on your breast cancer screenings. If you’re due, schedule an appointment with your PCP today – it is one of the most important things you can do for your health.
This article has been reviewed and approved by a panel of Privia Medical Group North Texas physicians.
This article contains information sourced from:
The American College of Obstetricians and Gynecologists
