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Breast Cancer
Breast Cancer Awareness Month is a Reminder to Get Screened

Breast Cancer Awareness Month is a Reminder to Get Screened

October is Breast Cancer Awareness Month and a good reminder to talk with your doctor about whether it is time for your breast cancer screening. Of course, being aware of your breast health is important all year long. No matter what month it is, we hope this information will encourage you to talk to your doctor about your breast cancer risk and what you can do to stay healthy.

Breast cancer survival rates continue to improve. The average 5-year survival rate for women with invasive breast cancer is 90% 1. If the cancer is located only in the breast, the five-year survival rate is 99%. One of the reasons these rates are so high is because we are catching breast cancer earlier, when it’s more treatable. This is thanks to screening tests like mammograms.

Preparing for your first breast cancer screening can be an intimidating experience. However, most women find that getting a mammogram is not a negative experience. How often you will need to get a mammogram depends on your age and health history. It’s important to follow your doctor’s recommendations for all health screenings, including mammograms. Here are 5 common questions to ask your doctor about breast cancer screening.

  1. Do I need a mammogram at this time?
  2. Are mammograms safe?
  3. How accurate are breast cancer screening tests?
  4. Do I need a 3D mammogram?
  5. If I’m at increased risk for breast cancer, do I need additional screening?

Breast Cancer Screening Frequently Asked Questions

Your primary care physician or OB/GYN can help you learn more about your individual breast cancer risk and provide screening recommendations for you. 

1. Do I need a mammogram at this time?

If you are over 25, you should talk with your doctor about your risk level for breast cancer. Guidelines may vary based on other risk factors as well. The American Society of Breast Surgeons offers the following recommendations for breast cancer screening:

  • Women with average risk of breast cancer:
    • that have non-dense breasts should get a yearly screening mammogram starting at age 40
    • that have increased breast density should get a yearly mammogram at age 40 and consider supplemental imaging
  • Women with higher-than-average risk:
    • that have genetic markers associated with higher cancer risk should start an annual MRI at age 25, then an annual mammogram starting at age 30
    • that have had prior chest wall radiation from age 10-30 should start an annual MRI at age 25, then an annual mammogram starting at age 30
    • with a risk of greater than 20% by any model, or a strong family history of breast cancer should start an annual mammogram and supplemental imaging starting at age 35 when recommended by your physician
  • Women with a prior history of breast cancer age 50 or more should get an annual mammogram
  • Women with prior history of breast cancer under age 50, or with dense breasts should get an annual mammogram and supplemental imaging when recommended by your physician

In addition, all women should perform breast self-examinations and be familiar with the way their breasts normally look and feel so changes can be reported immediately.

2. Are Mammograms Safe?

Yes. A mammogram is a type of X-ray, which means you will be exposed to a tiny bit of radiation. During a screening mammogram, typically two views of each breast are taken. Modern mammogram machines taking two views of each breast will expose you to about .4 millisieverts of radiation, which is less than a chest X-ray. For perspective, we are exposed to an average of 3 millisieverts of background radiation every year from our natural surroundings. The procedure takes about 20 minutes and discomfort is generally minimal.

In the past, it has been suggested that mammograms lead to the overdiagnosis of breast cancer since the screenings can find very small cancers that may never cause symptoms or problems. Given that it is impossible to tell which breast cancers would never cause problems, finding these early cancers saves countless lives.

3. How Accurate Are Breast Cancer Screening Tests?

Breast cancer screening tests are the most accurate way to detect breast cancer. A mammogram (the most common type of breast cancer screening) is 87% accurate in correctly detecting breast cancer. Sometimes, mammography results in a false positive result which requires additional testing. About 13% of the time, a mammography results in a false negative result. Be sure to follow up if your radiologist suggests additional tests.

Additional tests may include breast ultrasound or MRI. While follow-up testing can be stressful, it’s important to remember that a recommendation for these additional tests isn’t necessarily a suggestion of a positive result. Sometimes dense breast tissue requires a closer look. Many women who undergo additional screenings do not receive a breast cancer diagnosis.

4. Do I Need a 3D Mammogram?

Most women do not need a 3D mammogram. A 3D mammogram provides more images than a typical mammogram; however, some health insurance plans won’t cover it. A 3D mammogram might be a good choice if you have dense breasts or a personal history of breast cancer. Your doctor will help you understand your personal risks and recommend what type of mammogram you should get.

5. If I’m at Increased Risk for Breast Cancer, Do I Need Additional Screening?

It’s important to talk to your doctor about whether you are at a higher risk of developing breast cancer. Your risk factors may be increased due to genetic factors or other reasons related to your lifestyle. Risk factors for breast cancer include:

Genetic Risk Factors

  • Gender – Women are 100 times more likely to develop breast cancer.
  • Age – Women over 55 are at a higher risk.
  • Family history of breast cancer – Women with immediate family members who have been diagnosed with breast cancer may be at higher risk.
  • Personal history of breast cancer – If you’ve previously had breast cancer, you may be more likely to develop it again.
  • Dense breasts – Dense breasts make it more difficult to detect cancer on a mammogram.

Lifestyle Risk Factors

  • Drinking alcohol
  • Being overweight
  • Certain types of birth control

Even in women with increased risks, a mammogram is the most common initial screening for breast cancer. If you have a higher-than-average risk of breast cancer, your doctor may recommend that you begin screenings earlier and have them more often. Be sure to discuss any concerns you have about your risk for breast cancer with your doctor.

Breast Cancer Screening and Detection

If your doctor recommends you begin breast cancer screening, you will most likely be sent to a center that specializes in mammography and other methods of breast cancer detection and diagnosis. The most common screening for breast cancer is a mammogram. If the mammogram is abnormal or results are unclear, other tests like a breast ultrasound or MRI will likely be recommended.

If breast cancer is detected, you will be referred to an oncologist to begin treatment. Early detection leads to early treatment which is the best tool for a positive outcome. With today’s treatment options, including access to clinical trials, many women with breast cancer are able to live long, healthy lives. The first step, however, is to schedule your mammogram!

1 https://www.cancer.org/cancer/breast-cancer/understanding-a-breast-cancer-diagnosis/breast-cancer-survival-rates.html

Breast Surgery Q&A With Arizona Oncology Breast Surgeons

Breast Surgery Q&A With Arizona Oncology Breast Surgeons

October is a month we focus on Breast Cancer Awareness, so let’s speak directly with two of Arizona Oncology’s breast surgeons, Ronald Bauer, MD and Karen Hendershott, MD, FACS about their recommendations.

Q:  What are the latest techniques when it comes to surgery for breast cancer?

Dr. Bauer: There aren’t too many new surgical techniques in breast surgery right now. In general, we are doing more conservative procedures than in the past and relying more on radiation and new drugs given by medical oncologists. These treatments have a similar survival to the past aggressive surgical techniques without the morbidity of surgery.

Q: What should women consider when choosing between a lumpectomy with radiation and a mastectomy?

Dr. Hendershott: Choosing the right breast surgery depends on multiple factors. Do you have a genetic mutation that puts you at increased risk of additional breast cancers? Do you have enough breast tissue to remove all the cancer and still leave a nice cosmetic result? Are you able to have radiation treatment?

In women who don’t have a genetic risk of more breast cancers and are able to have all the cancer removed while preserving the breast, they are almost always best served by a lumpectomy with radiation. Lumpectomy with radiation has at least equal survival rates compared to a mastectomy, and recent data suggests there may actually be a survival benefit to lumpectomy because of the radiation. Local recurrence rates are slightly higher when the breast is preserved: a mastectomy has a 3-5% chance of recurring in the chest wall skin/small amount of remaining breast tissue while the recurrence rate after lumpectomy with radiation is typically around 10-15%. Women who take hormone blocking pills after surgery will reduce the risk of a local recurrence even more, so they have around a 6-8% chance of the cancer coming back in the breast or lymph nodes.

Dr. Bauer: I like to obtain a breast MRI after patients receive their diagnosis to make sure only one cancer is present and a lumpectomy then would be a possible option for treatment. I also have almost all of the newly diagnosed breast cancer patients undergo genetic testing with Dr. Walker. If they carry an actionable mutation, then bilateral mastectomies would be a safer choice for them either with or without reconstruction. The genetic testing is almost always covered by the insurance company, with the price coming down to around $250. The studies have shown that lumpectomy with radiation is equivalent to mastectomy when survivals are compared, so patients are not compromising their survival by selecting breast conserving surgery.

Q: Does having a mastectomy mean women can skip chemotherapy?

Dr. Hendershott: A common area of confusion is the difference between local treatments and systemic treatments for breast cancer. Many people mistakenly believe that doing a bigger surgery – a mastectomy – will change recommendations for chemotherapy. Because chemotherapy is designed to kill cancer cells that have already left the breast, the type of surgery that is chosen won’t change the possible need for chemo.

Q: What are the latest options to improve cosmetic outcomes after breast cancer surgery?

Dr. Bauer: More nipple sparing mastectomies are being performed with direct implant reconstruction with similar recurrence rates compared with non-nipple sparing mastectomies which were always done in the past. So less radical surgery is being performed with better cosmetic outcomes and similar survival to the past more aggressive procedures.

Dr. Hendershott: Increasingly, there has been a push towards “oncoplastics” which seeks to maximize the cosmetic outcome after breast conservation surgery. This can be done by the breast surgeon or in combination with a plastic surgeon. Moving around adjacent breast tissue or performing a breast lift and reduction at the time of the cancer surgery can often preserve the shape and contour of the post-lumpectomy breast. If needed, work can be done on the opposite breast to help them look more similar. 

Q: When should a bilateral mastectomy (both breasts removed) be considered?

Dr. Hendershott: There is no survival benefit to removing the healthy breast unless there is a genetic mutation. Removing both breasts more than doubles the risk of having complications after surgery. Both patients and physicians tend to overestimate the risk of developing cancer in the other breast. Studies have shown you have a 2-4% chance of developing cancer on the other side over the next ten years. When you consider that the average American woman has a lifetime risk of developing breast cancer of 12%, this means you would need to live at least 30 years after your original diagnosis to equal the chance your neighbor will get her first diagnosis of breast cancer. From a cancer perspective, it is often very reasonable to not remove the other breast.

Q: What if a woman is still having difficulty making a choice about her breast surgery?

Dr. Bauer: Patients should always ask what treatment their surgeon recommends and would they recommend it for their wife, sister or mother? That answer will put everything in perspective for them.

If you would like to speak with one of our breast surgical oncologists for a consultation or second opinion, we invite you to schedule a appointment at the Arizona Oncology office where they practice: https://arizonaoncology.com/physicians/

Can Men Get Breast Cancer?

Can Men Get Breast Cancer?

While certain cancers such as brain tumors are viewed as equally affecting men and women alike, other cancers are seen as gender specific. For instance, prostate cancer is identified as a type of cancer that only affects men for the simple reason that women do not have prostates. Breast cancer is widely recognized as being a common type of cancer that affects women. However, what isn’t talked about as much is the fact that breast cancer affects men as well. Let’s take a closer look at the signs, symptoms, risk factors, screening, and treatment options available for male breast cancer.  (more…)

Breast Cancer Awareness Events 2020

Breast Cancer Awareness Events 2020

More than likely, someone close to you currently has or has had breast cancer. According to the National Breast Cancer Foundation, Inc., 1 in 8 women will be diagnosed with breast cancer in their lifetime. Fortunately, great strides are being made in an effort to find a cure and eradicate breast cancer. October is breast cancer awareness month, a time to celebrate survivors, and support those who are currently battling breast cancer and those who will in the future. If you’re wondering how you can show your support during breast cancer awareness month and all throughout the year, then you have come to the right place. Let’s take a look at how you can take a stand against breast cancer. (more…)

Breast Cancer Awareness Month is a Reminder to Get Screened

What Is Metastatic Breast Cancer?

Metastatic breast cancer, which may also be referred to as Stage IV breast cancer, indicates that cancer has spread from the breast tissue and the nearby lymph nodes to other organs in the body, most commonly the bones, lungs, liver or brain. Any type of breast cancer (estrogen-positive, HER2-positive, etc.) can metastasize (spread) to other areas of the body.

When a tumor is found outside of the breast, it’s made up of breast cancer cells. For example, if you have a tumor in the lungs that is metastasized breast cancer, it contains breast cancer cells, not lung cancer cells. These cells may no longer react to the treatments given in the past, meaning that new cancer therapies may be necessary. 

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