Editor’s Note: This article is part of a partnership between chambanamoms.com and Christie Clinic.
By Candace McGregor, MD
The next time you are sitting with a group of other women, look around for a minute. If there are eight women in your group, it is likely that one of them will get breast cancer at some point in their lifetime. Is it one of them? Is it you? Are there things you can do right now and in the future to reduce this risk for you and your friends, partners, sisters, daughters? In this article, we will discuss answers to these questions, arming you with valuable information.
Let’s discuss normal breast tissue for just a minute. As you know, healthy breasts come in a wide array of sizes and breast size can change as women gain or lose weight. Breasts are made up mainly of two types of tissue: mammary tissue – the part that makes milk, and adipose tissue – otherwise known as fat. The mammary tissue is the milk producing factory that drains into the nipple through passageways called ducts. Breasts also contain blood vessels and lymph vessels.
What increases a woman’s risk of breast cancer? The short answer is – a lot of things. The long answer is listed here:
- Starting your periods at less than 10 years of age.
- Having no children or having your first pregnancy at an age over 30.
- Being diagnosed with a noncancerous breast disease.
- Having a first degree relative diagnosed with breast cancer.
- Having a history of radiation therapy to the chest earlier in life.
- Using a combination of estrogen and progesterone to treat symptoms after the menopause.
- Being overweight.
- Drinking more than seven alcoholic beverages per week.
*If you feel that more than one of these risk factors applies to you, your healthcare provider can use a variety of tools to help calculate your lifetime risk of breast cancer.
Can breast cancer be inherited? Yes. We believe that 5-10% of breast cancers are because of an inherited genetic mutation passed through the parents. This can be passed to children by the mother or the father. Women who have certain gene mutations including the BRCA mutations may have as high as an 80% chance of getting cancer in their lifetime. They may also have an increased risk of other cancers such as ovarian, uterine, colon, and pancreatic cancer. There are blood tests that can be used to detect these genetic mutations.
What should you be doing to monitor for breast cancer? A comprehensive breast cancer screening program includes three components:
- Breast self-awareness
- Clinical breast exams
Let’s address each one of these recommendations in more detail.
- Breast Self-Awareness: The American College of Obstetricians and Gynecologists along with the American Cancer Society have changed their previous recommendations from monthly self-breast examinations to what they now call “self-breast awareness”. Let’s talk about what this means. According to the American Cancer Society, “women should be aware of how their breasts normally look and feel and report any new breast changes to a health professional as soon as they are found.” Many women use showering as a time when they pay a little extra attention to the feel of the breasts. Over time, they learn what their breasts normally feel like. This is an example of breast awareness. Other women perform their own breast self-exams. To do this, a woman lies on her back with the arm extended behind her head. Using the finger pads of the middle three fingers on the opposite hand, the woman presses in a circular motion down into the breast tissue attempting to find anything that is more solid than the surrounding tissue. Oftentimes a lump will feel similar to a jelly bean or marble under the skin. The OB/GYN Department of Christie Clinic has laminated cards that you can hang in your shower that provide pictures and words to describe this process for your assistance.
What should a woman with lumpy breasts do if they are discouraged by previous attempts at self-breast awareness? I encourage women with lumpy breasts to draw pictures of where their normal lumps are so that they can realize when a new lump occurs by comparing new findings to their last drawing. Another way to help is to describe what you’re feeling to your provider so that they can discuss those particular areas with you during your clinical breast exam in the office.
- Clinical Breast Exam: The American College of Obstetricians and Gynecologists recommends a clinical breast exam be performed by your healthcare provider every year if you are over the age of 18. This can be performed by a provider in gynecology, internal medicine, or family medicine. This will be a careful examination of the breast tissue using both sight and touch. Slight to moderate amounts of pressure will be applied during the clinical exam and should not cause pain.
- Mammograms: A mammogram is a special type of Xray for the breast. The breast is compressed between 2 plates to flatten and spread the tissue. Then an Xray picture is taken. Abnormalities usually appear a much brighter white than the typical light gray of normal breast tissue.
The American College of Obstetricians and Gynecologists and the American Cancer Society recommend mammograms every year for you if you are over 40 while the United States Preventative Task Force recommends them every 1-2 years over 50. Early detection leads to significantly higher cure rates and long term survival. Findings from a large study in Sweden of women in their 40s who underwent screening mammograms showed a decrease in breast cancer deaths by 29 percent (Mayo Clinic).
There has been some concern voiced over the amount of radiation exposure a woman receives through mammograms. Because so many women are affected with breast cancer, the slight risk associated with the radiation is well worth it. The American Cancer Society says it this way: “To put dose into perspective, a woman who receives radiation as a treatment for breast cancer will receive about 5,000 rads. If she had yearly mammograms beginning at age 40 and continuing until she was 90, she will have received 20 to 40 rads.”
Another concern is that mammograms are uncomfortable. Now, I cannot possible argue against this fact. So, the only thing I can say is this; The average screening mammogram only takes about 3-5 minutes of pressure. You are strong enough to handle the discomfort for that brief period of time. One of the best ideas I saw was a women’s group that made a party of it. They all scheduled for the same late afternoon session on the same day. They brought refreshments and had a great time in the waiting room as each took their turn. What an awesome way to make a negative into a positive. They had a blast! So, if you have a group of ladies, make some calls, bring them with you. You just may be saving one of their lives.
Here are a few tips from the American Cancer Society about getting a mammogram.
- Try to schedule your mammogram at a time of the month when your breasts are not tender or swollen to help reduce discomfort and assure a good picture. Try to avoid the week right before your period.
- On the day of the exam, don’t wear deodorant or antiperspirant. Some of these contain substances that can interfere with the reading of the mammogram by appearing on the x-ray film as white spots.
If you have any further questions about breast health and screening for breast cancer, please call your provider. Information is key. Breast cancer is a real threat to the women we love. Help yourself and help the women around you keep themselves as safe as possible. Other resources include www.acog.org, www.cancer.gov, and www.cancer.org.
This article is not intended to provide specific medical advice and is not to be used or relied on for diagnostic or treatment purposes. Rather, this article is provided as an information resource only to help you better understand your health and does not create any patient-physician relationship.