BREAST CANCER

OCTOBER 2012

BREAST CANCER AWARENESS MONTH

 

One in eight women develops breast cancer. More than half are over age 50.

 Early detection correlates with better long-term health and cure.

The founding goal for Breast Cancer Awareness Month focused on educating women about the importance of obtaining mammograms for early diagnosis. The campaign began in 1985 as a partnership between the American Cancer Society and the drug division of Imperial Chemical Industries (now AstraZeneca). Awareness and evaluations have improved since its inception. Many supportive organizations have partnered to raise money for breast cancer research and help women obtain life-saving diagnosis and treatment.

Doing self breast exams can identify abnormalities and trigger life-saving interventions by a physician. Breast cancer experts may not agree on the frequency of mammograms, but women in high-risk categories typically start having mammograms by age 40 and continue annually. Nearly 75% of all women who develop breast cancer, have zero risk factors.

Recognized risk factors are: cancer in one breast increases your risk for additional unrelated or same type cancer in the other breast, family history, (familial breast cancer genes increase a woman’s risk to 85% chance of developing breast cancer, ovarian, pancreatic and other cancers over a lifetime). Other slight increased risk occurs in women who: give birth to their first child at age 35 or older; have early onset menses (before age 12); are overweight; experience late menopause (over age 55); consume alcohol daily. There are additional factors. For more information consult reliable websites such as: www.webmd.com/breast-cancer/guide

Most abnormalities found on mammograms are not breast cancer. Calcifications are usually non-cancerous and are related to aging. However, tiny specs appearing in clusters called “microcalcifications” raise concerns for cancer.

Mammograms often detect fluid-filled sacs called cysts. Sometimes an ultrasound of the breast is required to further evaluate the abnormality.  An ultrasound exam using noninvasive sound waves helps determine whether a lump is a solid mass requiring a possible biopsy or a benign cyst requiring no further treatment.

Breast cancer is not generic – there are many unique cell types, some more aggressive than others. Breast tissue consists primarily of lobules which produce milk and ducts that carry milk to the nipple. Fatty tissue enhances size, but the functional part of the breast is two fold: lobules and ducts. Most cancer originates in these two sites. Each cancer cell carries different protein markers on the cell surface. It is from these markers, called receptors that specific cancer types are identified and appropriate treatment of cancer determined. For more details on breast cancer see: www.cancer.org/cancer/breastcancer/detailedguide/

Breast cancer is a complex disease. There are many different cell types and treatment protocols available. Information on treatment plans and outcomes are shared by physicians internationally. Your local cancer specialist has current detailed information to provide the best treatments. Additional diagnostic methods are used including a breast MRI.

On a personal note, after having annual mammograms for years and a few weeks before my next scheduled mammogram,  I felt a lump. A needle biopsy revealed a high grade cell type: negative progesterone and negative estrogen receptors plus positive HER-2 receptors.  Approximately 200,000 new breast cancer cases are found each year; 25% of these are HER-2 + (Human Epidermal Growth Factor-2). This is an aggressive, fast growing form of breast cancer. I believe a self breast exam plus mammography, resulting in early detection, may have saved my life. Time will tell. There is a monoclonal antibody drug targeted specifically to HER-2 cell receptors. In fact there are two similar drugs now available. Following a double mastectomy, I opted for aggressive chemo therapy and a year of Herceptin, (a monoclonal antibody drug).

The over-all survival rate for women with breast cancer is 90%, a big improvement from a rate of 63% – 50 years ago. If the cancer is identified and treated before it spreads to the lymph nodes, survival at 5 years is 98%. Even if it has spread to local lymph nodes the survival rate at 5 years  is 84%. Knowing the incidence of breast cancer and the potential for long-term survival, if it is treated early, I encourage all women to do self breast exams, discuss any findings with a physician and obtain regular mammograms.
Betty Kuffel, MD

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