🎗️The Pettis Report: The Simplest (And Most Effective) Way To Detect Breast Cancer Early

Last month we discussed prostate cancer, one of the leading issues for men. This month, we’re shedding some light on breast cancer, the most prevalent cancer among women worldwide and the second-leading cancer for women in the US.

You’ve most likely seen someone donning the pink ribbon pin, both in October and throughout the year, to celebrate survivors, support current fighters, and honor loved ones lost to the disease. With 1 in 8 women getting diagnosed with breast cancer in their lifetime, it’s likely you know someone affected by the disease.

Despite greater awareness of breast cancer than many other cancers and illnesses, I’m always rather surprised when – during a routine yearly physical exam – a female patient of eligible age tells me she hasn’t had a recent screening mammogram. I’m even more shocked when a woman tells me she’s never had a mammogram!

We’ll talk about what causes breast cancer and how to reduce your risk – particularly the role that early and regular screenings play in preventing breast cancer. We’ll also cover how it is diagnosed and different treatment options.

What Causes Breast Cancer?

While risk is increased due to a combination of factors, it’s important to note some women will get breast cancer even without any of these. On the other hand, most women have some risk factors, but don’t get breast cancer. Not all risk factors have the same effect either.

If you have some of these preexisting conditions, your doctor can help determine the level of risk and how often you should take tests.

Let’s now investigate what are the main risk factors that influence the likelihood of getting breast cancer.

Age: Age and getting older remains the greatest risk factor. Most breast cancers are found in women who are 50 years old or older. Two out of three women with invasive cancer are also diagnosed after the age of 55.

Family History and Genetic Factors: Risk is significantly increased in women who have a family history of breast or ovarian cancer. This means having a first-degree relative (mother, sister, father, or child), or multiple family members on either the mother’s or father’s side of the family, who have been diagnosed with breast or ovarian cancer especially before the age of 50. However, more than 75% of women diagnosed with breast cancer have no family history.

Menstrual and Reproductive History: Early menstruation before the age of 12, and late menopause after age 55 increases the risk of breast cancer by exposing women to hormones longer. Studies also show that having at least one full-term pregnancy, especially before the age of 30, lowers the risk of developing breast cancer, with each additional birth further lowering the long-term risk. In addition, breastfeeding decreases the risk by reducing a woman’s total number of menstrual cycles.

Breast Density: Dense breast tissue means that the breasts have more connective tissue than fatty tissue. This can make lumps harder to detect and more difficult to see tumors on a mammogram, thus increasing the risk of getting breast cancer.

Other important determinants of getting breast cancer are genetic mutations and your personal health history. Women who have inherited changes (mutations) to certain genes, such as BRCA1 and BRCA2, are at higher risk of breast and ovarian cancer. Also, women who have had breast cancer before, or certain non-cancerous breast diseases, have a greater likelihood of being diagnosed again.

I’d also like to clear up some common myths – breast cancer is not caused or affected by microwaves, cell phones, plastic food-serving dishes, caffeine, wearing underwire bras, and deodorants and antiperspirants.

Symptoms & Detecting Breast Abnormalities

Self-breast examination is important and should be performed on a monthly basis at home. Being familiar with how your breasts appear, the normal texture, and any changes in nipple appearance can all provide valuable information and monitoring between yearly mammograms.

Different people have different symptoms of breast cancer, while some don’t have any signs or symptoms at all. Again, it’s essential to note what your breasts normally look and feel like. Keep in mind that this can be affected by having children, getting your period, gaining or losing weight, taking certain medications, and with age.

With that being said, some common warning signs of breast cancer are: lump in the breast or underarm, thickening or swelling of part of the breast, any change in the size or the shape of the breast, any changes to the nipple, and nipple discharge or blood (i.e. other than breast milk).

Classically, many breast abnormalities such as lumps, bumps, or nipple irregularities are detected by patients at home and confirmed in the clinic. If abnormalities are detected at home, your doctor will examine your breast in the office to further confirm and characterize the nature of the breast lesion. It’s called a clinical breast exam which involves your doctor feeling for lumps and making necessary referrals for further diagnostic examinations.

If you have any signs or symptoms that worry you, please make an appointment to see your doctor right away.

Screening & Ways To Reduce Your Risk

Mammography remains one of the few relatively low-cost, safe, and effective cancer screenings available. A mammogram is a simple x-ray of the breast tissue. It is done in an outpatient center and is one of the best methods for detecting breast cancer in its early stage.

Early detection is the best opportunity for early treatment and cure before the development of complications. On average, mammograms detect early breast cancer as many as five years earlier than they may be detected clinically, and routine screening has reduced breast cancer death by 30% over the last three decades.

Your doctor can help map out a personalized screening plan based on your risk level. Generally however, for people with average risk, routine screening should be initiated in all women at age 40 and repeated yearly thereafter.

Although mammograms and imaging tests are highly effective in detecting breast cancer and the best way to reduce your risk, it’s still important to perform self-breast examinations and to have clinical breast examinations by your doctor in the office. You can also read about other tests to diagnose breast cancer on the CDC’s website.

There are also certain lifestyle changes you can make to further reduce your risk:

Maintaining a Healthy Weight: Studies show that obesity and weight gain in older women, particularly those who have gone through menopause, puts them at higher risk of getting breast cancer. If you need to lose weight, start to slowly increase your level of exercise and improve your diet by reducing the number of calories you eat everyday. You can also consult your doctor for a personalized diet and exercise plan.
Exercising Regularly: In the same vein, being physically active can help you keep a healthy body weight and reduce your risk of developing breast cancer. Most healthy adults should target at least 150 minutes a week of moderate physical activity, or 75 minutes of vigorous exercise.
Reducing Alcohol Consumption: Your risk for breast cancer increases with the more alcohol you drink. As even small amounts increase risk, the American Cancer Society (ACS) recommends no more than one drink per day for women and no more than two per day for men.
Limiting Hormones: Taking hormone replacement therapy (HRT) during menopause can increase your risk for breast cancer. It also increases the risk of the cancer being detected at a more advanced stage. Certain oral contraceptives (birth control pills) also have been found to raise breast cancer risk.

Perform Tests Regularly

Good breast cancer screening measures are a combination of all these measures, so it’s important to do your part at home and encourage the women in your life to keep up with recommended screenings.

You have a large and important role in maintaining your breast health. The entire team at Metrolina Internal Medicine and I are eager to assist you to begin or continue to maintain your breast health.

Wishing you continued good health,

Karlton S. Pettis, M.D.

Sources

https://www.nationalbreastcancer.org/breast-cancer-facts

https://www.nationalbreastcancer.org/breast-cancer-risk-factors

https://healthmatters.nyp.org/6-facts-everyone-should-know-about-breast-cancer/

https://www.dosomething.org/us/facts/11-facts-about-breast-cancer

https://www.cdc.gov/cancer/breast/basic_info/index.htm

https://www.cdc.gov/cancer/breast/basic_info/symptoms.htm

https://www.cdc.gov/cancer/breast/basic_info/risk_factors.htm

https://www.cdc.gov/cancer/breast/basic_info/screening.htm

https://www.cdc.gov/cancer/breast/basic_info/mammograms.htm