The statistics are scary.
The American Cancer Society estimates that for the year 2013:
• About 232,340 new cases of invasive breast cancer will be diagnosed in women
• About 64,640 new cases of carcinoma in situ (CIS) will be diagnosed (CIS is non-invasive and is the earliest form of breast cancer).
• About 39,620 women will die from breast cancer
However, the American Cancer Society also says that early detection tests for breast cancer — such as screening mammograms — can save thousands of lives each year and that even more lives could be saved if more women and their health care providers took advantage of these tests.
We asked two local physicians to help explain the benefits and tools of early detection of breast cancer as well as anything women can do to protect themselves and decrease their odds of developing the disease.
The tools of early detection: mammography, self-exams, genetic testing, BREVAGen
While there appears to be some dispute among experts over the “when” mammography screening should begin — age 40 or age 50 — there is absolutely no disputing the “if” it should begin. Regular mammography screening exams remain the best means of early detection of breast cancer in women age 40 and over.
“There are multiple trials that prove the value of mammograms in the early detection of breast cancer,” said Paula Weisenberger MD, a medical oncologist with OHC, one of the largest independent oncology practices in the United States, with 17 offices all over southwest Ohio. “With mammograms, we have a tool that allows us to screen for breast cancer before it even causes symptoms or spreads. It’s non-invasive, relatively quick and the discomfort is minimal.”
The goal of screening exams, such as mammography, is to find the cancer before it starts to cause symptoms. The American Cancer society says that cancers found during these screening exams tend to be small and still confined to the breast, while cancers that are felt — such as during a breast self-exam — tend to be larger and are more likely to have spread beyond the breast.
“Breast self-exams are important and women should definitely know their own bodies, but mammography still far outweighs self-exams as a diagnostic tool,” Weisenberger said. However, she adds that mammography is not as reliable a diagnostic tool for women with particularly dense breasts — which is why mammograms are not recommended for women under 40, unless there is a family history of breast cancer.
Weisenberger also advises women to listen to their gut, as mammograms, while still their best line of defense in early detection, do sometimes generate false positives and negative results. “If your mammogram comes back normal but you still feel that something is wrong, you should take it further,” explained Weisenberger.
Genetic testing is another tool in the arsenal of early detection brought to light recently by actress Angelina Jolie. Though not recommended for everyone, the American Cancer Society says that genetic testing is sometimes suggested if there are:
• Several first-degree relatives (mother, father, sister, brother) with cancer, especially the same type of cancer
• Cancers in your family that are known to be linked to a single gene mutation (for instance – breast, ovarian and pancreatic cancer) – for breast cancer, testing looks for mutations in the BRCA1 and BRCA2 genes in a woman whose mother and sister had breast cancer
• Family members who developed cancer at a young age
“It’s important to note that less than 5 percent of women have these genetic markers,” said Weisenberger. Genetic counseling is often recommended if genetic testing is being considered.
BREVAGen is a test that determines a woman’s risk of developing sporadic, or non-familial, breast cancer. According to Breastcancer.org, over 85 percent of breast cancers occur in women who have no family history of cancer.
“In the Dayton area, the No. 1 cancer diagnosis is breast cancer, followed by prostate and colon cancer,” said Caroline Peterson, DO, Contemporary Obstetrics & Gynecology in Dayton. “Because of this, we’ve been looking for a test like BREVAGen to help identify and more aggressively monitor women who are at higher risk of developing the disease. With BREVAGen, we can get ahead of each woman’s personal risk and do something proactive about it for cancer detection and prevention.”
The test is administered in two parts. During part one, a patient is asked a series of questions designed to evaluate events in their life that could affect their clinical risk for breast cancer. The answers are used to compare that patient to others of the same age to determine risk. The second part of the test consists of a simple, non-invasive oral swab of the inner cheek, performed in the doctor’s office. BREVAGen looks for variations in DNA known as Single Nucleotide Polymorphisms, or SNPs. Since certain SNPs are associated with breast cancer, they can help predict a woman’s chances of developing the disease. It is important to note that this test provides information about breast cancer risk — it does not diagnose it.
Can breast cancer be prevented?
While there is no sure way to prevent breast cancer, there are certainly things that women can do to lower their risk and help increase the odds that if cancer does occur, it can be found at an earlier, more treatable stage. These include:
• Getting regular exercise
• Watching your weight
• Avoiding or limiting alcohol intake
“Women are often the caregivers of everyone else in the family,” Weisenberger said. “We think nothing of taking the kids to the doctor for check ups or when they’re sick, yet all too often, we don’t take the time to do the same for ourselves. We need to take care of ourselves so that we can be here for our families.”
For more information on the American Cancer Society’s recommendations for mammograms, visit: www.cancer.org. For more information about BREVAGen, visit www.brevagen.com or contact Contemporary Obstetrics & Gynecology at (937) 433-4325 or www.COBGYNDayton.com.
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