Living Jackson Magazine :: Breast Cancer

Breast Cancer

Woman’s Worst Enemy

By Milene J. Argo, MD, FACP

A growing epidemic, cancer is quickly becoming the leading cause of death in the United States. According to a 2004 report by the Centers for Disease Control, more than 550,000 people died of malignant neoplasm (cancer) in 2004, with over 41,000 of those deaths being women with breast cancer. October is National Breast Cancer Awareness Month, so use this article to make you aware of both the devastating effects cancer has had on humankind, but also the ways you can be proactive in preventing or detecting cancer.

Every woman in Jackson County is at risk for breast cancer. In the United States more than 211,000 new cases of breast cancer will be detected this year. Breast cancer affects one in eight women during a lifetime. Breast cancer kills more women in the United States than any other cancer except lung cancer. No one knows why some women get breast

cancer, but risk factors have been identified. Regular doctor visits for breast examinations and testing aimed at detecting breast cancer are important. When cancer is discovered early, you have more treatment options and a better chance of survival.

Research has shown that women with certain risk factors are more likely to develop breast cancer, but women with no risk factors can contract the disease. Studies have found the following risk factors for breast cancer:

Age: Aging increases your risk. Most cases of breast cancer occur in women over 60. The average 20-year-old female has a one in 1,985 chance of being diagnosed with breast cancer, while a 70-year-old woman has a one in 24 chance. Breast cancer is not common before menopause.

Personal History of Breast Cancer: A woman who had breast cancer in one breast has an increased risk of getting cancer in her other breast.

Family History: A woman’s risk of breast cancer is higher if her mother, sister or daughter had breast cancer, but women with no family history are also at risk. The risk is even higher if her family member was diagnosed with breast cancer before age 40 or if both breasts were affected.

Gene Changes: An inherited gene abnormality in genes called breast cancer genes 1 and 2 (BRCA and BRCA2) has been associated with some inherited forms of breast cancer. About 90-95 percent of women who get breast cancer actually do not have an inherited form of breast cancer or a mutated BRCA1 or BRCA2 gene.

Reproductive and Menstrual History: Having your first child after age 30 or never having children increases your risk of being diagnosed with breast cancer. Early menstruation before the age of 12 or late menopause after age 55 also increases your risk of contracting breast cancer. Breast-feeding seems to decrease your risk. Studies have shown that taking birth control pills for five years or longer may increase your risk of getting breast cancer. Currently or recently using combined estrogen and progesterone hormone replacement therapy may also increase your risk for breast cancer.

Certain Previous Precancerous Breast Changes: Having certain types of atypical hyperplasia or carcinoma in situ on breast biopsies increases the risk of breast cancer.

Previous Radiation Therapy to the Chest: Having had radiation therapy to the chest increases your risk of contracting breast cancer about 10 years after the radiation took place. Radiation is used to treat other forms of cancer including Hodgkin’s lymphoma.

Moderate Obesity: The relationship between obesity and breast cancer is complex but being moderately obese does seem to increase your risk.

Moderate Alcohol Intake: Greater than two alcoholic beverages per day increases your risk of contracting breast cancer.

Lack of Physical Activity: Women who are physically inactive throughout life may have an increased risk of getting breast cancer. Being active reduces the risk by preventing weight gain and obesity, other risk factors.

An early breast cancer detection plan should include breast examination by a physician every three years between the ages of 20 and 29, and every year thereafter. Monthly self-examinations beginning at age 20 are recommended. Baseline mammograms between ages 35 and 40 and yearly mammograms are essential. Keeping a personal calendar to record your self-exams, mammograms and doctor appointments can be very helpful.

During a breast exam performed by your doctor, your healthcare provider will look for differences in size or shape between the breasts. The skin of your breasts is checked for rashes, dimpling or other abnormal signs. The doctor will feel the breast tissue looking for lumps. Some breast cancers may not be detected during examination.

You can perform monthly breast self-exams to check your breasts for any changes in the skin or lumps. Familiarity with what is normal for your breasts is important and will help you detect subtle changes in your breasts. Feel for a lump or thickening in or near the breast or in the underarm area. Compare the breasts for changes in size or shape. The nipple may turn inward or the skin of the breast may be scaly, red or swollen. The skin of the breast may have ridges or pitting so that it looks like the skin of an orange. Check the nipple for discharge or tenderness. Early breast cancer does not necessarily cause pain. In fact, most breast cancers have no symptoms.

Mammograms are X-ray pictures of the breasts. They are the best tools doctors have to find breast cancer early. They can show a breast lump before it is felt during examination. They can also show a cluster of tiny specks of calcium. Cancer, precancerous cells, or other conditions can cause lumps or specks. If your mammogram is abnormal, a more detailed mammogram may be in order and an ultrasound or an MRI of your breasts may be performed. If an area looks suspicious for cancer then a piece of tissue will be obtained for further evaluation.

Know that every woman is at risk for breast cancer. Become familiar with the normal feel of your breast by performing your monthly self-exams. See your doctor to schedule a clinical breast exam and discuss further testing. All three tests will help you detect this disease in your breasts early and may save your life. Remember that breast cancer is best treated when detected early.

Milene J. Argo is Board Certified in Internal Medicine and holds offices in Commerce and Homer as part of the Hill Medical Group.