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October 2008: Breast Cancer Facts

01 Oct 2008

Dr. Olivera Raskovich has a special interest in women’s health, of which breast health plays an important part. Dr. Raskovich’s article below identifies important ways women can identify and fight breast cancer. Additionally, Weiss offers discounted screening mammography during May and October, an important tool in the fight against breast cancer.

Breast Cancer Facts 

Dr. Olivera Raskovich
Lakefront Medical Associates
Weiss Memorial Hospital
(773) 564-5355

Among women, breast cancer is the most common cancer and the second leading cause of cancer deaths, behind lung cancer. If eight women were to live to be at least 85 years of age, one of them would be expected to develop the disease at some point in her life. Two-thirds of women with breast cancer are over age 50, and most of the rest are between 39 and 49 years old.

What causes breast cancer?
Although the precise cause of breast cancer is unclear, we know what the main risk factors are. Among the most significant factors are advancing age and a family history of breast cancer. Risk increases slightly for a woman who has had a benign breast lump and increases significantly for a woman who has previously had cancer of the breast or the ovaries. A woman whose mother, sister or daughter has had breast cancer is two to three times more likely to develop the disease, particularly if more than one first-degree relative had been affected. We have now identified two genes responsible for some instances of familial breast cancer, called BRCA1 and BRCA2. About one woman in 200 carries it. Having the gene predisposes a woman to breast cancer but does not ensure that she will get it.

Generally, women over 50 are more likely to get breast cancer than younger women, and African-American women are more likely than Caucasians to get breast cancer before menopause.

The link between diet and breast cancer is debated. Obesity and drinking more than a couple alcohol drinks a day, may promote the disease.

Symptoms and signs
In its early stages, breast cancer usually has no symptoms. As a tumor develops, you may note a lump or pain and tenderness in the breast, swelling in the armpit, noticeable flattening on the breast or any change in size, contour, texture or temperature of the breast.

Diagnosis and tests
Fortunately, breast cancer is very treatable if detected early. Localized tumors can usually be treated successfully before the cancer spreads. For this reason, you should be sure to have an annual medical checkup, perform monthly breast self-examination and get mammograms.

Starting at around age 20, examine your breasts every month, three to five days after your period ends. If you are no longer menstruating, examine your breasts on the same day of each month.

The American Cancer Society recommends having a baseline mammogram, an X-ray of the breasts, between the ages of 35 and 40, and then a screening mammogram every year after age 40. Screening mammograms are recommended annually for all women starting at age 40, even if they are asymptomatic, meaning that they have no signs or symptoms of breast disease. In a screening mammogram, each breast is X-rayed in two different positions: from top to bottom and from side to side. Potential abnormalities are found in 6 to 8 percent of women who have screening mammograms. This small group of women needs further evaluation that may include diagnostic mammography, breast ultrasound or needle biopsy. After the additional evaluation is complete, most of these women will be found to have nothing wrong. Mammography is 85 to 90 percent accurate. Breast lumps can be identified on a mammogram up to two years before they can be felt.

How does an abnormality appear on a mammogram?
A potential abnormality on a mammogram may be called a nodule, mass, lump, density or distortion.

  • A mass (lump) with a smooth, well defined border is often benign. Ultrasound is needed to characterize the inside of the mass; if the mass contains fluid it is called a cyst.
  • A mass (lump) that has an irregular border or a star-burst appearance (speculated) may be cancerous and a biopsy is usually recommended.
  • Microcalcifications (small deposits of calcium) are another type of abnormality. They can be classified as benign, suspicious or indeterminate. Depending on the appearance of the micro calcifications on the additional studies (magnification views), a biopsy may be recommended.

Breast cancer treatment
There are two major goals of breast cancer treatment:

  1. To rid the body of cancer as completely as possible.
  2. To prevent cancer from returning.

The type of treatment will depend on the size and location of the tumor in the breast, the results of lab tests done on the cancer cells, and the stage or extent of the disease. Your doctor usually considers your age and general health as well as your feelings about the treatment options.

What are the types of breast cancer treatment?
Breast cancer treatments are local or systemic. Local treatments are used to remove, destroy or control the cancer cells in a specific area, such as the breast. They include:

  1. Surgery, either mastectomy or lumpectomy, also called breast conserving therapy or partial mastectomy with or without lymph node removal.
  2. Radiation Therapy, systemic treatments that are used to destroy or control cancer cells all over the body. They include:
  • Chemotherapy, which uses drugs to kill cancer cells. Side effects can include nausea, hair loss, early menopause, fatigue and temporarily lowered blood counts.
  • Hormone therapy, including tamoxifen and aromatase inhibitors Arimidex, Aromasin and Femara. Hormone therapy uses drugs to prevent hormones, especially estrogen, from promoting the growth of breast cancer cells that may remain after breast cancer surgery. Side effects can include hot flashes and vaginal dryness.
  • Biological therapy such as Herceptin, works by using the body’s immune system to destroy cancer cells. Herceptin targets cancer cells that have high levels of protein called HER2.

Systemic therapy can be given after local treatment (adjuvant therapy) or before (neoadjuvant therapy). A patient may have just one form of treatment or a combination, depending on her needs.

Next steps for a healthy future
Understanding the causes and symptoms of breast cancer can greatly increase our ability to successfully stop and overcome breast cancer. Women must remain vigilant in their steps to identifying breast cancer early. To this end, Weiss offers a screening mammography special during both May and October that costs $80 (this also includes the radiologist interpretation). Patients many not use their insurance in conjunction with this offer. Patients must still see their doctors to secure an order for the screening mammography.

Once you’ve obtained your doctor’s order, please call (773) 564-7777 to schedule your screening mammography. When you call, simply tell the scheduler that you want to participate in the mammogram special. If you need a physician, please contact Lakefront Medical Associates at (773) 564-5355.