October is National Breast Cancer Awareness Month. Seeing the pink everywhere is a great reminder for all of us to take a moment and make sure we have done everything we can to reduce the risk of developing breast cancer.
Since breast cancer seems to strike at random, it is a feared disease for many women in the United States. That is why it is so important to be screened.
There is a lot of conflicting information out there about when and how you should be screened. However, here are the guidelines from the American College of Obstetricians and Gynecologists, the authority on women’s health in the United States.
There are three basic ways all women of average risk can be screened for breast cancer: breast self-awareness, clinical breast examination and mammography.
Breast self-awareness is pretty much what it sounds like. If you feel any lumps, see any changes in the skin, or notice any nipple discharge, call your doctor. According to American College of Obstetricians and Gynecologists, about one half of all cases of breast cancer are found by women themselves just by being aware of changes in their breasts. You do not need a formal time or day to examine your breasts. However, it is extremely important to have an understanding of how your breasts normally feel and look as well as being aware of, and reporting, any changes.
A clinical breast exam is an additional tool in your screening arsenal. When added to mammography, it improves breast cancer detection from 88.6 percent to 94.6 percent. Women aged 20-39 should have clinical breast exams at least every one to three years, while women aged 40 and older should have them annually.
Mammography is the final screening test for women at average risk for breast cancer. Mammograms can potentially detect a mass three years before it becomes palpable. If we can detect the tumor in the early state, we can treat the patient with a 98 percent, five-year survival rate and a 90 percent, 10-year survival rate without recurrence of the disease. This is why the American College of Obstetricians and Gynecologists recommends mammograms every year starting at 40 years old.
While it is clearly an excellent tool for detecting breast cancer (as seen with those numbers above), mammography is not without its downfalls. Mammograms do have the potential for false-positive and, to a lesser extent, false-negative results. Patients should go into these tests understanding the possibility of false results. If you get a positive result, you will need to undergo additional tests such as imaging and potentially even biopsies.
Those three tools are recommended for screening women who are at average risk for breast cancer. Some women, such as those with the BRCA gene mutations, are at higher risk and may need additional screening (such as MRIs and more frequent clinical breast exams). Women who have the BRCA gene mutations have a 65-74 percent chance of developing breast cancer in their lifetimes. In comparison, all women in the general population have a 12.4 percent chance of developing breast cancer in their lifetimes.
Some women of certain cultural backgrounds have a much higher rate of the BRCA gene mutations. Women of Eastern European Jewish descent (also known as Ashkenazi Jewish heritage) have a 1 in 40 chance of carrying the BRCA1 or BRCA2 gene mutations. The BRCA gene mutations also occur at a higher rate in the French Canadian population.
Because the mutations can be passed down through both male and female family members, you should take a good look at your family history of breast and ovarian cancer, as well as your family’s background. Share this information with your doctor to see if you should be screened for these mutations. It is also important to pass this information on to your children.
This month of awareness is an excellent opportunity to talk to your friends and family about the importance of screening for breast cancer and researching your full family histories. While cancer can make us sometimes feel helpless, at least we have the power to do some things to lessen the risk.