CANCER CURE & PREVENTION SERIES: Breast Cancer Screening: Essential for All Ages

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Most of us have a family member or close friend who has been diagnosed with this dreaded disease that affects so many women. The good news is that breast cancer is highly treatable and often curable. Treatment usually involves some combination of surgery, radiation therapy, chemotherapy and hormonal therapy. Coordination of care amongst the various specialists is critical. Another area that has been debated recently is about screening and early diagnosis. In this month’s article, Dr. Frankie Ann Holmes presents the rationale behind early diagnosis and discusses the current guidelines.
– Vivek S. Kavadi, M.D.

By Frankie Ann Holmes, MD, F.A.C.P.
Over the past decade, news and information about breast cancer has helped increase awareness about the disease tremendously. While awareness of breast cancer has improved, the disease unfortunately remains the second-deadliest cancer among American women.

Early detection with regular mammograms remains the single most effective way to combat breast cancer. As physicians, we know that the earlier we can detect the disease, the more likely the patient will survive. When detected early, before it spreads to the lymph nodes or elsewhere, women have a 99 percent survival rate at five years.

While this all may sound very simple, at my Texas Oncology practice, I see many women with more advanced stages of breast cancer. It is estimated that this year alone in Texas, 17,348 women will be diagnosed with breast cancer, and 3,178 women will die from the disease. Many of these deaths are preventable with yearly mammograms, especially for women over the age of 40.

While mammograms will detect most breast cancers in women who don’t have symptoms, they are not the only way to detect the signs of breast cancer. Women should be familiar with the usual appearance and feel of their breasts at different times during their monthly cycle or during menopause. We call this “breast awareness.” If there are unusual changes, they should contact their doctor. Breast awareness has been shown to be a more effective method of finding cancers early than breast self-exam, which often caused women to find non-cancerous lumps and unnecessary testing or biopsies.

Clinical breast exams are recommended for women in their 20s and 30s every three years and every year for women over 40 for the early detection of breast cancer. For women with greater than 20-25 percent lifetime risk of breast cancer, that is twice the usual risk, women age 40 and older may benefit from an annual breast MRI screening. Finding breast cancer in early, more treatable stages leads to higher survival rates.

Screening is especially important for women who have increased risk factors for breast cancer. However, it is important to remember that even women without clear risk factors should have regular screenings and mammograms. Risk factors may include:

Age: Approximately two-thirds of invasive breast cancer cases occur in women over age 55, though the disease can occur at any age.

Family history: If a woman’s mother, sister, or grandmother had breast cancer or ovarian cancer, that woman has an increased risk for breast cancer.

Diet and exercise: Overweight and/or physically inactive women face a higher risk of developing breast cancer.

While screenings may detect cancer early on, it’s also important to watch out for warning signs and symptoms, including:
A lump in the breast
Change in breast size or shape
Redness, scaliness, or thickening of nipple or breast
Dimpled skin near the breast
A lump under the arm
Nipple retraction
Nipple discharge
Irritation on the breast, nipple, or skin near the nipple
Swelling of the breast

If any of these symptoms are detected, contact a physician immediately to start receiving proper medical care.

Researchers continue to make advances in the fight against breast cancer every day. Until a cure is found, regular screenings, awareness, and healthy lifestyle choices are among the best tools a woman has to reduce her risk and survive the disease.

Dr. Holmes

Dr. Frankie Ann Holmes is a medical oncologist specializing in breast cancer at Texas Oncology–Memorial City, 925 Gessner St., #550 in Houston, Texas.