October is Breast Cancer Awareness month. So here are some facts about this disease.
The average woman has a 1 in 11 risk of developing breast cancer before age 75. Although the risk rises with age, breast cancer can be diagnosed at any age.
Screening mammography programs have been targeting women aged 50 to 70. However, in Canada, women over 40 may be screened as well. Screening mammograms for women between age 40 and 50 has been shown to reduce cancer deaths; however, because the disease is less prevalent than in older women, there is a higher rate of false positives (i.e. the mammogram detects an abnormality but the patient does not have cancer).
Screening mammograms have also been shown to reduce cancer deaths in women up to age 75. Therefore, a woman should discuss with their family physician when they should start and stop screening mammograms.
Risk factors for breast cancer include: (1) age (as stated above, the risk increases with age); (2) family history (especially in a first degree relative such as a mother, daughter or sister under age 50 or before menopause); however, 9 out of 10 woman who have been diagnosed with breast cancer do not have any family history. Some woman mistakenly believe that they are unlikely to have a breast cancer if they have no family history.
(3) being overweight (especially after menopause); (4) drinking more than 2 standard alcoholic drinks per day; (5) taking hormone replacement therapy for more than 5 years after menopause; and (6) having a first child late in life or not having any children at all.
There is some controversy regarding breast self-examination. Current medical evidence has not demonstrated that monthly self-examinations reduce breast cancer deaths. This seems counterintuitive as many women have discovered breast cancers because of a new area of breast tenderness or a palpable lump. If they had not done any examination at all, their cancers may have been discovered when much further advanced.
Some of the symptoms of breast cancer include: abnormal lymph nodes (felt as firm lumps) in the arm pits or above the collar bones, changes in the skin of the breasts (including dimpling or puckering, changes in visible veins or sores), changes in a nipple (including inversion, bleeding or discharge), a palpable lump (that may or may not be tender), or a new area of breast tenderness.
Although any of these breast symptoms will be understandably alarming, they may be due to benign causes. However, it is important to see a physician you trust to assess them appropriately.
Women with a family history of breast cancer should speak to their doctor about their personal risks. Depending on the details of that family history, some women may be eligible for specific genetic testing.
All women should talk to their family physician about breast health and the timing of the most appropriate screening tests for breast cancer.