Early Detection Saves Lives––

In The Fight Against Breast Cancer Vigilance Is The Key

By Jan Howard

Breast cancer now causes more deaths among women than any other cancer except lung cancer, according to the American Cancer Society.

All women are at risk for breast cancer, and the risk increases with age. Many breast cancers may be treated successfully, but the chances for success are highest when cancers are found early. The best protection is to detect it as early as possible and treat it promptly.

This was the message conveyed by Patrice Hough, RN, BSN, manager of the Praxair Cancer Center at Danbury Hospital.

Ms Hough’s presentation, “Replace Fear With Facts,” was part of a Women’s Health Awareness Fair sponsored by Lockwood Lodge at Ashlar of Newtown and Connecticut VNA on May 20. The fair included health screenings, professional speakers, demonstrations, and programs on Lyme disease prevention and awareness, breast cancer prevention and detection, and others.

“There is so much in the media that makes women fearful. But if you can find it early, you can survive breast cancer,” Ms Hough said.

Cancer, she explained, is a group of diseases that occur when cells grow abnormally, causing a lump or mass. Most breast cancers are slow growing, she said.

Early diagnosis is the key, Ms Hough said, noting the importance of screening through mammography, clinical breast examination, and breast self-examination.

 Screening includes self-breast examinations for ages 20 and over, clinical breast examinations for ages 20 to 39 every three years, and yearly for ages 40 and over. Mammography is recommended every year beginning at age 40 and earlier if there is family history.

Mammography, Ms Hough said, is the “best test we have now” to diagnose breast cancer earlier.

Self-breast examinations should be done once a month at the same time, about a week after the menstrual period or, if no longer having regular periods, on the first day of the month. Women should ask their health care provider to teach them the proper way to do a thorough breast self-exam, the American Cancer Society advises.

Signs to look for include a new lump or thickening in any part of the breast, change in breast size or shape, dimpling or puckering of skin, swelling, redness, or warmth that does not go away, pain in one spot that does not vary, nipple discharge, or an itchy, sore, or scaling area on the nipple.

“Know your body and your breasts,” Ms Hough advised. “It’s important to know your own body. Look for changes in shape, puckering of skin, or nipple discharge.” Palpitate the breasts using fingertips, covering the entire area, doing light palpitation, then deeper.

After age 40, have a clinical breast exam, which includes a visual exam and palpitation, by a health care provider every year. “Do it near the time of your mammogram,” she said. “The best time is before the mammogram.”

Mammography detects 90 percent of breast cancers, Ms Hough said. “Compression of the breast is important.”

Regular screening can reduce breast cancer deaths by as much as 25 to 30 percent for women over 50, she said.

There is a 20 percent chance that mammography will miss a tumor, but with a clinical breast exam that chance is decreased to about five percent.

Other tests might include ultrasound or magnetic resonance imaging (MRI).

The incidence of breast cancer is increasing in women, she said, but it can occur in rare instances in men. Of 40,200 breast cancer deaths last year, 39,800 were women.

There are more than 200,000 new cases of breast cancer yearly in the United States. In Connecticut this year there have been 2,600 new cases of breast cancer and 500 deaths, Ms Hough said. The good news is that death rates are decreasing in younger women and African American women.

Risk factors include being a woman; over age 50; personal history of breast cancer; and history of breast cancer in family, such as mother, sister, or daughter. Most cases however, occur in women without a family history, according to the American Cancer Society.

Other risk factors include hormonal factors, late age at first birth, fewer pregnancies, obesity, and alcohol consumption, among others.

The incidence of breast cancer increases with age. More than 96 percent occurs in women over 40. At age 20, the risk is one in 2,044; at 60, one in 29; and at 70, one in 24, Ms Hough said.

If a lump or mass is found, a biopsy is done. Only one out of five women who have a biopsy will have breast cancer.

The stage of the cancer is determined by the size of the tumor, spread to other areas, and involvement of lymph nodes.

“I recommend when people have some concern, go for a surgical evaluation first,” Ms Hough said.

A diagnostic mammogram and ultrasound may be ordered as well as a surgical evaluation, she noted.

Treatment could entail surgery, which may include lumpectomy, followed by radiation therapy, or mastectomy, removal of the entire breast. Additional treatments may include chemotherapy or hormones, she said.

“There is dramatically different treatment today,” Ms Hough said. Rather than total breast removal as in the past, most breast cancers are now treated with breast conservation.

Survival depends on the stage at diagnosis. According to the American Cancer Society, 85 out of every 100 women diagnosed with breast cancer will survive at least five years. Survival is much better if the disease has not spread.

More than 95 percent of women who were diagnosed early with breast cancer, survive.

Ms Hough said women should follow the recommended screening guidelines. “Only 67 percent go for mammography,” she said. “If you have a family history, have a discussion with your doctor regarding early screening and genetic counseling.”

Not having insurance is no reason not to have mammography, she said, because there are programs that would help with the costs.

Ms Hough emphasized healthy living as preventive care, including regular exercise, eating healthy, limiting alcohol, maintaining a healthy weight, taking care in the sun, and not smoking.

“More women die of lung cancer than from breast and ovarian cancer combined,” Ms Hough said. “Do monthly self exams, have a clinical breast exam yearly, and have a mammogram.”