Many of us are aware that breast cancer is the second most common cancer-causing death in women, surpassed only by lung cancer. The U.S. Department of Health and Human Services notes this disease affects one of every eight women throughout their lifetime. But with early detection and treatment in initial stages, the five-year survival rate is ninety-nine percent. As October is National Breast Cancer Awareness month, this is a time for all women to consider their risks.
Early detection is critical to best outcomes. There are many common changes that may be found such as lumps, nodules or changes in skin tissue. Many of these findings, however, may not be breast cancer. But early familiarization performing a monthly breast self-exam is beneficial beginning in early adulthood. Your primary care provider will routinely perform a clinical exam as a part of your annual wellness physical. Most abnormal finding may require additional evaluation in conjunction with your physical. Direction for performing a self-exam should be included in your visit if you require instruction. As well, there is a wealth of information and instruction online, including http://www.nationalbreastcancer.org and www.ncbi.nlm.nih.gov.
As women get older, there is an increasing incidence of cancer with age. As well, women who have a family history of breast, uterine, ovarian or colon cancer, have been on hormones, or those who have never had children or not had children until later in life are at greater risk. There is also a laboratory evaluation known as BRCA gene mutation testing to determine a significant increased risk of cancer, especially if there are multiple family members with a history of breast cancer. There are as well, increased risks associated with smoking, daily alcohol consumption, prior radiation therapy and obesity. Common misconceptions that do not increase the risk include underwire bras, antiperspirant use and implants.
The most common imaging study to aid in breast health is the mammogram. It is normally included as a preventive health benefit by most insurance carriers. Then National Cancer Institute recommends annual screening mammograms in all women 40 to 74. Those with family history should consult your physician. The benefit of early detection is to see subtle changes that are not yet large enough to be felt on exam. And comparative views each year may be able to confirm stability or detect a subtle change. Additional studies that may be indicated in breast evaluation include ultrasound, MRI and, if needed, biopsy.
There are many organizations promoting awareness, walks for cancer, fundraisers, research, support and education. So ‘guys’, encourage the women close to you to participate in breast cancer awareness. And please, ‘gals’, you as well, starting with the one in the mirror.
Bradford Croft, DO
East Flagstaff Family Medicine