Detecting cancer early is best defense

Breast Cancer Awareness Month is a reminder of the importance of self exams and mammograms.

By SUSAN ASCHOFF

© St. Petersburg Times,
published October 30, 2001

October is Breast Cancer Awareness Month.

About 3-million women in the United States are living with breast cancer: 2-million who have been diagnosed and an estimated 1-million who do not yet know they have the disease, reports the National Breast Cancer Coalition.

"There is nothing a woman can do to ensure that she will not get breast cancer," the coalition says.

But Breast Cancer Awareness Month reminds every woman that early detection is critical and an annual mammogram her best defense.

No one knows what causes breast cancer.

Scientists have discovered some risk factors: Obesity, alcohol abuse, long-term hormone therapy, early onset of menstruation and late onset of menopause, having no children or giving birth at a later age and family history all have been indicated as contributors.

But they account for only small increases in the odds.

A Seattle study published this month found that women who work nights and who are frequently awake during early-morning hours may be at increased risk. Results are preliminary, but researchers believe nighttime exposure to light may suppress production of melatonin, a brain hormone, and increase levels of estrogen, which stimulates growth of breast tissue, including cancer cells.

Another study, reported by the Associated Press in September, found that women who are physically active, whether doing chores around the house or hustling on the job, reduce their chances of getting cancer. Unclear from the mid-1990s research is whether activity resulted in a healthier body weight, already recognized as a factor in preventing disease, or if there were other beneficial life choices made by the women in the Canadian study.

About 40,000 women die of breast cancer each year in the United States. About 400 men will die of the disease this year.

The key to survival, say the experts, is to catch breast cancer in its early stages.

Monthly self-examinations to search for lumps, cysts, dimpling, redness or other changes in the breasts are recommended, as is an annual mammogram for women over 40. Mammography, an X-ray image of the breast tissue, is the single most effective method for early diagnosis, detecting abnormalities 76 percent to 94 percent of the time, reports the Institute of Medicine.

Mammograms are less effective for women under 40 because their breast tissue is denser and more difficult to read on film. However, any woman whose mother or sister had breast cancer at an early age is advised to have mammograms before age 40.

Self-examination or an examination by a physician is statistically almost as effective as mammography in finding a suspect lump or change in the breast.

An Institute of Medicine committee recently evaluated more than a dozen other technologies for breast cancer detection, including ultrasound, computer-aided systems and magnetic resonance imaging, with mixed results.

There is no cure for breast cancer. But when it is discovered early and confined to the breast, the five-year survival rate is more than 90 percent, figures show.

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