Though breast cancer remains the most common cancer among women (second only to skin cancer), significant advances have been made in the early detection and treatment of the disease in recent decades. As a result, more and more women diagnosed with breast cancer are joining the ranks of survivors.
As Shaili Desai, MD, of The Toledo Clinic Cancer Centers explains, “We’re definitely making strides against breast cancer. Since the 1990s, death rates have been declining, and compared to the 1980s, we’re seeing far fewer deaths from metastatic, or stage 4, breast cancers. We can attribute this positive trend in large part to two factors: earlier detection of breast cancers and new systemic and adjuvant chemotherapies.”
Know the symptoms
Dr. Desai points out that a vital aspect of breast cancer awareness is learning to recognize the symptoms the disease can cause. Pain or tenderness of the breast is a common symptom, but other potentially concerning signs include (among others) the presence of a lump, mass, or thickening in the breast or the armpit area; nipple discharge; skin changes on the breast or nipple area, such as redness, rash, or a scaly sore; inversion of a nipple or other part of the breast; dimpling or puckering of the skin; or a sudden change in the shape or size of a breast. Though having one of these symptoms doesn’t necessarily signal breast cancer, it does warrant a prompt evaluation by a healthcare professional.
Know your risk
Factors that increase women’s risk of developing breast cancer include advancing age, family history of breast cancer (having a first-degree relative with the disease), having undergone hormone replacement therapy, alcohol use, tobacco use, obesity, late onset of menopause or early onset of menstruation (increases lifetime exposure to estrogen, which feeds many breast cancers), and certain hereditary mutations, such as the BRCA1 or BRCA2 gene mutation.
Though inherited mutations are linked to only 5 to 10% of all breast cancer cases, Dr. Desai, emphasizes that women with these mutations should get tested because they will likely need different monitoring. “Women with these inherited disorders may need more frequent mammograms and possibly breast MRIs. They may need to start screening at an earlier age as well as more frequent gynecological exams. Some may also need prophylactic surgery to lower their risk,” she says.
Dr. Desai further explains that it’s critical for women with a family history of breast cancer to inform their doctor who was diagnosed, at what age, and what form of malignancy it was. The next step is to see a genetic counselor who will get a detailed history from the patient and family to help determine who is at risk for developing breast cancer, who is a candidate for genetic testing, and how they should be monitored.
Know your treatment options
Women diagnosed with breast cancer should explore all treatment options with their oncologist—and those options are expanding. Dr. Desai notes, “Breast cancer treatment is becoming more and more complex, but for the better. Not only are there more options for treating patients, but they’re becoming more targeted and individualized, so patients usually tolerate them better and have better outcomes versus traditional chemotherapy,” she adds.
Know what you can do for prevention
With respect to breast cancer prevention, Dr. Desai’s best advice is, “First and foremost, get regular mammograms. There’s some controversy over when women should start getting screened, but we follow American College of Radiology guidelines, which recommend beginning at age 40. Beyond that, try to make healthy lifestyle modifications that reduce breast cancer risk, such as avoiding smoking, limiting alcohol to no more than one drink per day, maintaining a healthy body weight, and exercising regularly. These are all habits we can control but society tends to ignore.”❦