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Breast cancer: Early detection is key

Is prevention possible?

While researchers have yet to come up with a clear-cut breast-cancer prevention plan, scientific evidence suggests that certain factors may affect a woman’s risk of developing the disease:

  • Physical activity. Although the jury is still out on the effects of exercise on breast cancer, it appears that regular physical activity may provide some protection. Researchers suspect that exercise’s effect on hormones and the immune system may explain the benefit.
  • Alcohol consumption. An analysis of the results of more than 50 studies suggests that consuming two or more alcoholic drinks a day may increase breast cancer risk.
  • Obesity. Being overweight, particularly after menopause, appears to increase a woman’s breast-cancer risk. This is one more incentive to reach and maintain a healthy weight.
  • Designer estrogens. Tamoxifen, a drug long used to treat breast cancer, has been found to protect women at high risk for the disease. In one large study, raloxifene, another “designer estrogen,” was as effective as tamoxifen at preventing invasive breast cancer, and it has recently been approved by the FDA for this purpose in some women.

One in eight. You probably know that’s how many women will get breast cancer at some point in their lives. Here’s a statistic you may not know: 98 percent. That’s how many women with localized, or stage 1, breast cancer are alive five years after diagnosis, according to the American Cancer Society.

That high survival rate drives home the importance of detecting breast cancer before it spreads. Some less comforting statistics also help make that point: For women whose cancer has spread regionally prior to detection, the five-year survival rate drops to 81 percent. And when the cancer has spread far from the breast to other organs by the time of diagnosis, that figure drops all the way to 26 percent.

So what’s the best way to detect breast cancer in its earliest stages? Follow the screening program described here. Studies show it saves lives.

  1. Have a clinical breast exam at least once a year. Your doctor will first look at your breasts for changes in size or shape. He or she will then gently palpate (feel) your breasts.
  2. Get a yearly mammogram. Mammography can identify breast cancer several years before symptoms develop. Getting regularly scheduled mammograms—the American Cancer Society (ACS) recommends a yearly mammogram for women age 40 and over—can bring great peace of mind. Ask your doctor for a schedule that’s right for you. After all, most women who undergo the low-dose X-ray exam learn that they do not have breast cancer. And even if the test indicates the presence of cancer, a woman who has been receiving regular mammograms can be reasonably confident that the disease has likely been caught at an early stage.

    Mammography is highly accurate, detecting about nine in 10 cases of breast cancers in women who show no symptoms. It is slightly more accurate in postmenopausal women; studies over the last 30 years have shown that regular screening mammograms among women ages 50 to 69 can reduce deaths from breast cancer by 30 percent. Yet data from the 1997 Behavioral Risk Factor Surveillance System indicate that older women are less likely than younger ones to have had a mammogram—an unfortunate finding, as breast cancer risk rises steadily with age.

  3. If you are at very high risk for breast cancer, ask your doctor about getting a magnetic resonance imaging (MRI) scan along with your annual mammogram. The ACS recommends this screening test beginning at age 30 for women who have the BRCA1 or BRCA2 breast cancer genes, had radiation treatment to the chest between ages 10 and 30 or have certain other risk factors. Women who have not been tested for breast cancer genes but have a close relative with the genes should consider this screening test also.
  4. Report any changes in your breasts to your doctor. Breast self-exams, optional for women over 20, should be performed on the same day every month. If you are still menstruating, choose a day soon after your period, when your breasts aren’t tender or swollen.

    To perform a self-exam, lie down, put a pillow under your right shoulder and place your right arm behind your head. Use the finger pads (the top thirds) of the three middle fingers of your left hand to examine your right breasts for lumps or thickening. You can follow a concentric pattern, moving in smaller and smaller circles from the top of your breast to the nipple; proceed straight up and down; or start at the nipple and move outward, examining one section of your breast at a time until you have completely circled the nipple. By following the same pattern every month, you’ll cover the entire breast and will be best able to notice any changes. Pay special attention to the area between the breast and the underarm. Feel for any unusual lump or mass.

    After using your right hand to examine your left breast, stand in front of a mirror and look for dimpling of the skin, changes in the nipple, redness or swelling. Gently squeeze the nipple and look for discharge.


© 2014 Dowden Health Media