Get Those Mammograms!
One of the most difficult and gut-wrenching aspects of being a physician is when we have to give bad news about a person's health to that patient or the family. I still remember the look in the 34-year old woman's eyes when I had to give her bad news concerning the findings from her recent breast biopsy. Sara, whose eyes welled up with tears and with hands shaking, then proceeded to ask what to tell her four-year-old daughter and husband of nine years. In my mind, I was thinking medical school never prepared me for this, but I needed to be honest, yet encouraging because there were still more tests to take, and we needed to be optimistic. Fortunately, for Sara and her family, the cancer was found early and was removed. Now, some six years after the diagnosis, she is doing well without any evidence of recurrence.
Here are some facts, some good and some bad Next to skin cancer, breast cancer is the most common cancer among women. To give you a number, the American Cancer Society estimates that 178,700 new cases of invasive breast cancer will be diagnosed in the United States in 1998. This number makes breast cancer the second leading cause of cancer death for women, exceeded only by lung cancer. However, breast cancer is the leading cause of cancer death for women between 40 and 55 years of age. Believe it or not, I do have some good news to report: the breast cancer death rate has been decreasing over the past few years. This is a very good trend, and has most likely been due to the increased screening of women, including good breast self-examinations (BSE) and regular mammograms. Another very important key is that women are gaining knowledge about breast cancer and are becoming very involved in their own health care.
Yes. There are some patterns to breast cancer that have been identified. It has been clearly shown that the incidence of breast cancer increases with age. Women over age 50 are at greater risk, with about 77 percent of all new breast cancers being identified in this age group. An interesting fact is that men can get breast cancer, but it is 100 times more common in women. Having a close blood relative from either side of the family (mother, sister or daughter) with breast cancer is an additional risk factor, as is a previous history of receiving prolonged irradiation of the chest area as a young adult or child to treat another cancer such as Hodgkin's disease or non-Hodgkin's lymphoma.
Other risk factors include women who started menstruating at an early age (before age 12), or who began menopause after age 50. Drinking excessive alcohol has also been linked as a risk factor. Current studies are ongoing concerning tobacco, but we do know that this addictive product has been linked to other cancers. A controversial issue is whether estrogen replacement therapy or the use of birth control pills increases the risk of breast cancer. Please discuss this with your physician because your individual health history is very important in deciding whether or not to use estrogen. However, I want to stress that just because you have a risk factor does not mean you will get this cancer. It does mean, however, that you need to have a regular health check-up by your personal physician.
Good news! When breast cancer is diagnosed at an early stage, it greatly increases the chance of being successfully treated. Here are the current American Cancer Society guidelines for the early detection of breast cancer.
Women age 40 and over should have a screening mammogram every year. Some screenings may start earlier depending upon your own personal situation.
Every woman 20 and older should learn how to do a proper breast self-examination (BSE). Please have a health care professional show you the proper method. Don't be shy about making sure you understand and are able to do this properly. You should do this the same time each month (for women not having periods) or approximately 7 days after your period ends, when your breasts are not tender or swollen. By regularly examining your own breasts, you will get to know what is "normal" for you. Please report any changes to your health care professional!
Between 20 and 39, a health care professional should give you a clinical beast exam at least every three years, more often if there are concerns. Once you reach age 40, this should be done yearly.
That is tremendous news. HOWEVER, if you feel an irregularity or notice a change in your nipples, perhaps a discharge or change in appearance, please explore this further. Make sure you see a physician who is skilled and experienced with breast abnormalities. If you feel something unusual and your mammogram is normal, please see your physician. This may need further investigation. Fortunately, most breast lumps are benign (not cancer), however you deserve to have a thorough exam in order to allay your concerns.
Remember, you know your body better than anyone else. Please, make sure you get your questions or concerns answered. And, if you have had a mammogram or other procedure and have not heard from your physician, don't always assume the results are normal. Make sure you follow up by calling the office for the results.
For further information, you can call the American Cancer Society at 1-800-ACS-2345. Remember that old adage, "an ounce of prevention..." Well you know the rest
