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Health

Knowledge: the best defense

This month, all the forces that fight breast cancer close ranks. But though research and fund-raising remain vital, individual awareness is the most crucial weapon.

By NANCY PARADIS
Published October 10, 2006

Breast cancer may well be every woman’s worst nightmare.

Nearly 213,000 women in the United States, about 13,000 of them in Florida, will be diagnosed with breast cancer this year. More than 40,000, including an estimated 2,500 Floridians, will die of it this year.

It is more on our minds now because October is National Breast Cancer Awareness Month. In addition to emphasizing the need for early detection, the month is the time for countless events to raise money for research and treatment.

With early detection — before the cancer has had a chance to spread — the five-year survival rate is 96 percent. Knowledge about the disease is the best defense, and following the guidelines given here could save your life.
St. Petersburg radiologist Brent Price says that mammograms can detect lumps up to two years before they can be felt. “Mammography is the No. 1 test for detecting breast cancer,” he said. “It is relatively fast and inexpensive.”
Price, who studies X-rays as a diagnostic tool, said he discovers one case of breast cancer for every 200 to 250 mammograms he views. That incidence is higher than the average because his patients often have problems or elevated risk factors.

In spite of the ability of mammograms to detect breast cancer when the disease is most treatable, 70 percent of all cases are found through self-exam.

If the mammogram result is questionable, a sonogram is performed, which may then be followed by a biopsy of any lump that suggests cancer. An MRI, or magnetic resonance imaging,  is most often used in cases where a previous surgery has altered the breast.

Are you at risk?

There are a number of risk factors for developing breast cancer. Just being female is the prime one, although one in 100 victims is male. Other factors include:

- Age: the likelihood of developing breast cancer increases with age.

- Family history: when a mother, sister or daughter has developed the cancer before age 50.

- Changes in genes specific to breast cancer, known as BRCA1 and BRCA2.

- Early onset of menstruation and late menopause: before age 12 and after age 55, respectively.

- Late or no pregnancies.

- Long-term (more than 10 years) use of birth control pills (in women under age 35) and estrogen replacement therapy.

- Obesity.

- Diet high in saturated fat.

- Alcohol consumption: two or more drinks daily.

How to find out

The key to early detection is screening.

Dr. Joseph Mace, a medical oncologist with Gulfcoast Oncology in St. Petersburg, notes that although the incidence of breast cancer is increasing, a significant portion is being reported earlier, so the screening measures are doing their job. “Those (cases) are the ones we can cure,” Mace said.

Here are the screening guidelines recommended by the American Cancer Society and other  organizations:
Monthly breast self-examinations, beginning at age 20. Women should know how their breasts normally look and feel and should promptly report any changes or lumps to their health care provider.

Clinical breast examinations,  by a doctor, every three years from ages 20-39, then every year.

A baseline mammogram, an X-ray that is the standard diagnostic test, should be performed by age 40 — earlier for those at high risk.

Mammograms every one to two years for ages 40-49.

Annual mammogram after age 50.

[Last modified October 10, 2006, 07:39:10]