Breast cancer primer

Increased awareness and advances in treatment help women face the challenge with greater confidence.

Beverly McLeod, M.D.

October is National Breast Cancer Awareness Month, and while many women would prefer simply not to think about the disease, an important step in protecting yourself is to learn all you can.

Breast cancer is the most common cancer diagnosis in women (excluding nonmelanoma skin cancer) and second only to lung cancer in the number of deaths. In 2008, more than 182,000 new cases of breast cancer in women will be diagnosed in the United States, according to the American Cancer Society (ACS), and more than 40,400 deaths will occur. However, the positive news is that finding breast cancer early ultimately improves patient outcomes.

Early detection

The five-year survival rate among women with breast cancer improves if the cancer is diagnosed at an earlier stage.

Women have a better chance of surviving breast cancer today than at any other time in history. Death rates in women have actually declined since 1990, thanks to improvements in detection, advances in treatment and increased awareness. The five-year survival rate among women with breast cancer improves if the cancer is diagnosed at an earlier stage. For women whose disease is diagnosed when it is localized, the survival rate is 98 percent.

For the best chance at catching breast cancer early, all women should know which screening methods are available. Breast self-examination—checking your own breasts for lumps and changes to the tissue—is the first line of defense. Many women have been diagnosed at early stages because they felt something that wasn’t normal and had it checked out. Having it “checked out” means visiting your doctor and getting a clinical breast examination (CBE) followed by a mammogram.

Important screenings

CBEs detect 14 to 21 percent of breast cancers. The ACS recommends that women ages 20 to 39 have a CBE every three years. Women ages 40 and older should have them annually.

Studies have found that having a CBE combined with mammography reduces the risk of dying from breast cancer by 30 percent. Women with a strong family history of breast cancer should start having annual mammograms as early as age 35. Those with average risk should have them every one to two years beginning at age 40, and every year after age 50.

Although family history does play a role in the likelihood of developing breast cancer, it’s important to remember that the majority of women diagnosed with it have no known risk factors.

What to look for

Common symptoms of breast cancer include a change in texture or appearance of the breast or nipple and nipple discharge. It’s certainly better to be safe than sorry, so see your doctor right away if you have any of these symptoms.

    If you are diagnosed with breast cancer, there are numerous treatment options available, including the following:

        •    Surgery with lumpectomy or mastectomy
        •    Radiation therapy, usually after lumpectomy
        •    Chemotherapy after definitive surgery and for patients whose disease is spreading
        •    Hormonal therapy
        •    Biological therapy (agents that boost the immune system)

    Your doctor will work with you to choose the treatment option that’s best for you.