3 steps to breast cancer early detection
October 25, 2016
By Katie Coakley, brought to you by Kaiser Permanente.
You might have seen those pink ribbons popping up around town. October is Breast Cancer Awareness Month, designed not only to help those affected with the disease through early detection, education and support services, but also to increase awareness of the disease.
The facts are startling. About one in eight women in the United States (about 12 percent) will develop invasive breast cancer in their lifetime. While the risk for men is less, about one in 1,000 men will develop breast cancer, it's still a risk. And while death rates have been decreasing since 1999, approximately 40,450 women in the U.S. are expected to die in 2016 from breast cancer.
However, there is hope. Not only has the overall death rate decreased, but fewer women under 50 have died due to breast cancer. These decreases are thought to be the result of treatment advances, earlier detection through screening and increased awareness.
To assist in awareness and education, Dr. Carol Venable, internal medicine physician at the Kaiser Permanente Frisco Medical Offices, offers these tips for early detection of breast cancer.
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1. Talk to your doc
"The best tip for early detection is discussing your personal risk profile with your primary care provider," Venable said. "We can give you an idea of what your calculated risk is. If you have a significant family history of breast cancer or certain other risk factors, we may start screening even earlier than age 40, or you may warrant a discussion about the pros and cons of genetic testing."
Screening is the best tool that doctors have for early detection. While a self-exam used to be the common recommendation, the most recent guidelines from the American Cancer Society recommend against self-breast exam. Mammography is a better test.
"For decades, we thought there were benefits to self breast exam and an exam by a provider," Venable explained. "Unfortunately, the data have not shown a benefit for either of these. Neither the U.S. Preventive Task Force nor the American Cancer Society recommends either of these.
That being said, both note the importance of knowing one’s own baseline, and as a provider, I have to tell you that I often still do clinical breast exams for this same reason."
2. Schedule a screening
In the past, there was an accepted rule for when to have a mammogram. However, just as self-exam has been proven less effective, there is no longer a cookie-cutter answer based on age and gender. Now, the patient's risk is also taken into account and screening is based on that.
"Women with high risks of breast cancer can start screening very early, depending on their specific situation," Venable said. "These are typically the women who warrant genetic testing for mutations associated with breast cancer."
For women with average risk, the question as to the starting age and frequency of mammograms is more difficult. There are at least ten different guidelines and recommendations currently out there, all of which have subtle differences that providers take into account.
The consensus is that women aged 50 – 74 should get mammograms either yearly or every other year. For women 40 – 49, the best recommendation is to start talking to your health care provider, making the correct decision for you based on the individual level of risk (genetics, personal history of breast cancer, etc.).
3. Early detection is key
No one wants to hear that they have breast cancer. However, catching it early is the best bet scenario.
"I would say that early detection is important if what you are detecting early is something that is treatable and would have caused you harm or death if you had not found it," Venable said. "Some of what we detect early with breast cancer are non-aggressive, slow-growing tumors that would not have resulted in harm. However, some of what we detect is aggressive and would have led to death that is preventable or capable of delay with prompt treatment. "
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