What You Need to Know
About Breast Cancer
As Breast Cancer
Awareness Month draws to a close, we are here to provide the information you need to take care of yourself throughout the year.
“The thought of having breast cancer is frightening,” says Sharp Malak
, M.D., M.P.H., Interim Director of the UAMS Breast Center
. “Approximately 75% of women diagnosed with breast cancer have no family history of breast cancer or other factors that put them at high risk for developing the disease. That is why every women 40 and older should be screened on a yearly basis.”
“By not getting a yearly mammogram after age 40, women increase their odds of dying from breast cancer, and treatment for any advanced cancers ultimately found will be more extensive and expensive,” says Dr. Malak.
3-Step Plan for Preventive Care
Step 1. Breast self-exam (BSE)
The American Cancer Society says that breast self-exams are a choice for women ages 20 and older as a means of familiarizing themselves with their breasts so they can notice changes more easily. These exams should be done regularly at the same time every month. Regular self-exams teach you to know how your breasts normally feel so that you can more readily find any change. Changes may include:
- Development of a lump
- A discharge other than breast milk
- Swelling of the breast
- Skin irritation or dimpling
- Nipple abnormalities (pain, redness, scaliness or turning inward)
If you notice any of these changes, see your health care provider as soon as possible for evaluation. If you have any questions, talking with your health care provider about the benefits and limitations can help you decide if you should start performing breast self-exams.
Step 2. Clinical exam
A breast exam by a health care provider or nurse trained to evaluate breast problems should be part of a woman's physical exam. The American Cancer Society recommends:
- Between ages 20 and 39, women should have a clinical breast exam by a health professional every three years.
- After age 40, women should have a breast exam by a health professional every year.
If you have any questions, talk to your health care providers about your personal risk factors to make a decision about having a clinical breast exam.
A clinical breast exam by a health care provider or nurse is very similar to the procedures used for breast self-exam. Women who routinely practice breast self-exams will be prepared to ask questions and have their concerns addressed during this time.
Step 3. Mammography
Mammography is a low-dose X-ray of the breasts to find changes that may happen and is the most common imaging technique. Mammography can find cancer or other problems before a lump becomes large enough to be felt. It can also assist in the diagnosis of other breast problems, but a biopsy is required to confirm the presence of cancer.
Experts have different recommendations for mammography. Women should talk with their health care providers about their personal risk factors before making a decision about when to start getting mammograms or how often they should get them.
A diagnostic mammogram may be needed when a questionable area is found during a screening mammogram.
If you are at increased risk for breast cancer, you should talk with your health care provider about whether to begin having mammograms at an earlier age.
What are the different types of breast cancer?
There are several types of breast cancer, including:
- Ductal carcinoma is the most common type and begins in the lining of the ducts.
- Lobular carcinoma is another common type, and it occurs in the lobules (milk-producing glands).
- Paget disease is a rare form of breast cancer that begins in the glands in or under the skin. It is often characterized by inflamed, red patches on the skin. Because Paget disease often originates from breast duct cancer, the eczema-like cancer usually appears around the nipple.
- Inflammatory breast cancer is a rare form of invasive breast cancer. Usually there is no lump or tumor; instead, this cancer makes the skin of the breast look red and feel warm. The breast skin also looks thick and pitted, much like an orange peel.
- Triple negative breast cancers are breast cancers (most often invasive ductal carcinomas) that do not have estrogen receptors and progesterone receptors, and do not have an excess of the HER2 protein on the cancer cell surfaces. These breast cancers tend to occur more often in younger women and in African-American women. They tend to grow and spread faster than most other types of breast cancer.
What is the BRCA test?
This blood test checks for mutations in the BRCA1 and BRCA2 genes. Mutations in these genes can raise the risk for certain cancers, especially breast cancer (in both men and women) and ovarian cancer in women. In both men and women, BRCA1 and BRCA2 mutations raise the risk for other types of cancers.
The BRCA genes are the most common cause of gene-related breast and ovarian cancers. In the U.S., 5% to 10% of all breast cancers and 10% to 15% of all ovarian cancers in white women are related to BRCA mutations.
You may choose to have the BRCA test if you have a personal or family history of breast cancer and want to learn more about your risk. Insurance companies may cover the cost of this test if you have a family history of cancer.
If the test shows that you have a gene mutation, you can take steps to protect your health. This may include having breast cancer screenings more often.