With Breast Cancer Awareness Month approaching what better time is there than now to talk with your doctor about your risk for breast cancer and screening and early detection?
Except for skin cancer, breast cancer is the most common cancer in American women. More than 300,000 will be diagnosed with the disease this year alone.
Fortunately, when breast cancer is detected early it is often treatable.
Today, as the American Cancer Society notes, there are more than 3.1 million breast cancer survivors in the United States thanks in large part to finding breast cancer early through screening and increased awareness, as well as better treatments.
The University Medical Center of Princeton Breast Health Center offers sophisticated breast care technologies, including 3D mammography, for the detection and treatment of breast cancer.
Age and gender are the two biggest risk factors for developing breast cancer. While breast cancer can affect men, it is 100 times more common in women and the risk goes up with age.
Other risk factors include:
• Changes in breast cancer-related genes (BRCA1 or BRCA2)
• Having your first menstrual period before age 12
• Never giving birth, or being older when your first child is born
• Starting menopause after age 55
• Taking hormones to replace missing estrogen and progesterone in menopause for more than five years
• A personal history of breast cancer, dense breasts or some other breast problem
• A family history of breast cancer
• Getting radiation therapy to the breast or chest
• Being overweight, especially after menopause
Most of the time there are no symptoms with breast cancer. It is usually found in a mammogram or as a lump in the breast that isn’t painful. Other warning signs may include:
• Thickening in the breast
• Redness, swelling, warmness or darkening of the breast
• Puckering or an indentation in the skin visible when you lift your arm over your head
• Pulling or tightening in the breast
• Pain or tenderness not tied to your monthly cycle
• Nipple tenderness, discharge or physical changes to the nipple such as inversion
While other conditions can cause these symptoms, any change in your breast should be checked by your doctor.
Though the guidelines for screening mammograms may have changed in recent years, it remains clear that mammograms save lives. A mammogram is a low-dose radiation X-ray that is used to look inside the breast. Mammograms can detect cancers when they are very small and still confined to the breast.
The UMCP Breast Health Center offers the latest in mammography technology — a procedure known as digital tomosynthesis. The procedure produces a 3D view of the breast by taking multiple X-rays of breast tissue slices. For many patients, especially those with dense breast tissue, 3D mammography offers a clearer view of the breast compared with traditional 2D technology.
Some studies have suggested that 3D mammography might lower the chance of being called back for follow-up testing, and may also be able to find more cancers.
Decisions about when to start screening, the frequency of screening and when to end screening are unique to every woman and should be discussed regularly with your doctor.
With an emphasis on shared decision-making, the American Congress of Obstetricians and Gynecologists this summer updated its recommendations for screening mammography. They recommend:
• Woman at average risk of breast cancer should be offered screening mammography at age 40. If they have not initiated screening in their 40s, they should begin screening by no later than age 50. The decision about the age to begin mammography screening should be made through a shared decision-making process. This discussion should include information about the potential risks and benefits.
• Women at average risk of breast cancer should have screening mammography every one or two years based on an informed, shared decision-making process that includes a discussion about the benefits and harms of annual and biennial screening and incorporates patient values and preferences.
• Women at average risk of breast cancer should continue screening mammography until at least 75 years. Beyond age 75, the decision to discontinue screening mammography should be based on a shared decision making process informed by the woman’s health status and longevity.
Lower your risk
When it comes to lowering your risk for breast cancer, there are some things that are simply beyond your control like age, gender and family history.
However, there are certain steps you can take to lead a healthy lifestyle and reduce your risk, including:
• Maintaining a healthy weight
• Limiting alcoholic drinks to no more than one per day
• Avoiding exposure to chemicals that cause cancer
• Breastfeeding any children you have, if possible
• If you are taking hormone replacement therapy, talking to your doctor about the risks and benefits
For women with a family history of breast cancer or inherited changes in the BRCA1 or BRCA2 genes, there are medicines, as well as preventive surgery, that could help reduce the risk for developing the disease.
Since the first Breast Cancer Awareness month was celebrated in the 1980s, tremendous progress has been made in screening and treatment for breast cancer. New screening technology in addition to advanced surgical options and new medical and radiation treatments have improved outcomes over the past several decades.
Breast cancer can be treated successfully if it is detected early. Talking to your doctor is the first step.
The National Accreditation Program for Breast Centers (NAPBC), a program administered by the American College of Surgeons, awarded the three-year full accreditation to the breast care services provided at UMCP and the UMCP Breast Health Center in East Windsor.
The UMCP Breast Health Center has also been designated a Breast Imaging Center of Excellence by the American College of Radiology, signifying that UMCP meets the highest standards of the radiology profession.
For more information or to make an appointment, call 609-688-2700.
To find a physician with Princeton HealthCare System, call 888-742-7496 or visit
www.princetonhcs.org.
Rachel P. Dultz is fellowship trained breast surgical oncologist and board certified surgeon as well as a fellow of the American College of Surgeons. She is the medical director of the Breast Health Center at University.
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