Breast Cancer facts
What do i need to know?
by Jamal Ross
Breast is the most cancer amongst women in the United States. About 1 in 8 women will be diagnosed with breast cancer in the United States. This comes to about 12% of women. Breast cancer is the second leading cause of death in the United States and worldwide breast cancer is the most common cancer related death amongst women. Let’s discover more interesting facts about breast cancer symptoms, screening and risk factors.
When we look at the symptoms of breast cancer, the classic symptoms involve a woman detecting a firm mass in her breast tissue that appears to be difficult to move. We call this an immobile mass. Yet, most breast cancers in the United States are detected on mammography. A mammogram is a special type of x-ray where two plates are used to compress the breast tissue in order to get more information about certain masses or calcium collections that may be within the breast. From this mammogram a score is given. This score is called a BIRADS score. BIRADS stands for “Breast Imaging Reporting and Data System” and was developed by the American College of Radiology to create a standardized system for reporting all mammogram results. BIRADS scores generally range from 0 to 5. Also, it’s not enough to know if you have a positive or negative mammogram, but to know your BIRADS score and what this means in terms of breast cancer risk. Later in this series we will discuss breast cancer symptoms and BIRADS scores in detail.
Furthermore, we expect to receive some guidance from our medical societies regarding when to obtain a mammogram. There are several different medical societies that give recommendations in terms of when to get a mammogram including: the American Cancer Society, American College of Obstetricians and Gynecologists, American College of Physicians, American College of Radiology, United States Preventative Tasks Force and the National Comprehensive Cancer Network. Amongst all these organizations, none of them recommend getting a mammogram at the age of 40. At the time of this writing, only the American Cancer Society recommends performing a mammogram at the age of 45. Notwithstanding, all these medical societies have universal agreement that mammogram should begin at the age of 50 for woman at normal risk. If you are at higher risk for breast cancer, you will require mammogram earlier in life. After the age of 75, it is an personalize decision as to whether a woman would like to continue with mammogram for breast cancer screening.
Here’s the difficult part. Are there women that have breast cancer in the 40s? Yes. Are there women that have breast cancer in their 30s? Yes. Yet, various medical society guidelines do not provide strong recommendations for every woman in their 30s or 40s to obtain a mammogram. From the perspective of these medical societies, the possibility of missing a certain number of cancers for women in their 30s and 40s outweighs the anxiety, cost and pain involved with breast biopsies for the vast majority of women in this age group who find masses on mammograms that do not end up being cancerous. In all, you just have to know yourself well. If you are concerned about your symptoms, you should get a mammogram. If you have a strong family history of breast cancer or an unknown family history, you should get a mammogram. Taking part in a shared decision making process with your doctor, while considering your risk and personal choices, is always a good idea.
There are also several important risk factors for breast cancer, including age. Specifically, the risk breast cancer increases with age, with women in the 60s and 70s being at the highest risk. Risk is also associated with lifetime exposure to estrogen. So, the age at which you start your menstrual cycle, the number of children you have or the age at which you begin menopause may also have an effect your lifetime exposure to estrogen and hence your risk of breast cancer. On the other hand, exercise and adequate vitamin D can decrease your risk of breast cancer. During our breast cancer series, we will discuss risk factors in greater detail as well.
There are some women that are the highest risk of breast cancer. These women have a hereditary form of breast cancer and may be affected by the BRCA gene mutation. BRCA stands for BReast CAncer gene. Those with the BRCA mutation have a 50 – 87% risk of developing breast cancer and 20 -45% chance of developing ovarian cancer in their lifetime. The BRCA gene has also been associated with cancer of the prostate and pancreas. During this series we also discuss the BRCA gene in detail and clues for woman, and men, to know if they should receive genetic testing based on family history. Finally, we will discuss breast biopsies and certain phrases you should look for in a biopsy report.
This series contains a lot information, but I know you are ready. Feel free listen to a podcast episode more than once. Take notes and prepare questions for your doctor. Whenever we are dealing with something as widespread and impactful as breast, we need to do everything we can to educate ourselves about this disease and how to prevent it. We also need to know the gaps in a prevention technique so that we can ensure that we do not fall through the gaps.