Screening and Early Detection of Breast Cancer: Who is at Risk?

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Touloukian WebCoastal Cancer Center’s Dr. Emily Touloukian appears as a featured contributor in the October editions of SC Woman Magazine and Transitions, both of which are on newsstands now. In the article below, Dr. Touloukian shares with local women the importance of recognizing the signs and symptoms of breast cancer, the advantages of yearly mammograms and when you should begin preventative screenings.


Screening and Early Detection of Breast Cancer: Who is at Risk?
By Dr. Emily Touloukian, Coastal Cancer Center

Breast cancer is the most commonly diagnosed cancer in women, and the statistics prove it. One out of every eight women will be diagnosed with breast cancer at some point in her lifetime. It is estimated that in 2013, over 230,000 women will be diagnosed with invasive breast cancer and over 40,000 women will die from the disease.

Early detection of breast cancer by screening is a very important part of effective treatment. When breast cancers are localized to the breast at the time of diagnosis, 98% of women survive more than five years after their diagnosis.

Screening for breast cancer helps health care professionals detect these early breast cancers before symptoms occur. Usually these cancers are smaller and contained within the breast. Breast cancers that are found because they have caused symptoms are usually larger and more likely to have spread beyond the breast. Signs and symptoms of breast cancer include:

   – A lump or swelling  in the breast or underarm
   – Skin irritation or dimpling
   – The nipple turning inward
   – Discharge from the nipple
   – Breast or nipple pain

If you notice any of these changes in your breast, you should be evaluated immediately by a health care professional.

For most women, screening for breast cancer includes both clinical breast examination and mammography. A clinical breast examination should be done by a health care provider (a physician, nurse practitioner or physician assistant) as part of a general health examination at least every 3 years for women in their 20s and 30s with an increase in frequency to every year at age 40. Monthly breast self-examinations can help you get to know how your breasts normally look and feel. Therefore, if a change occurs such as development of a lump or skin change, you will be readily able to identify the difference and bring it to the attention of your health care provider.

Screening mammography has become an important tool used to detect breast cancers before symptoms are apparent. The increased utilization of mammograms has led to more breast cancers being diagnosed at an early stage when treatments can be more effective and a cure more likely. Mammography is a very accurate screening test for breast cancer; however, like most testing, it is not perfect.

The American Cancer Society currently recommends that all women over the age of 40 years who are an average risk for breast cancer should have a mammogram every year for as long as they are in good health. If you have an abnormal mammogram it may be recommended that you have additional testing done to further evaluate the abnormality, such as a second mammogram, ultrasound or biopsy.

Women who are at a higher risk than average risk of breast cancer may be advised to start having mammograms at an early age or additional testing, such as magnetic resonance imaging (MRI). Factors that may place a woman at increased risk for breast cancer include:

   – A personal or family history of breast cancer
   – First menstrual period before age 12
   – Menopause after age 55
   – A personal history of breast biopsies
   – Previous chest radiation for another cancer
   – The presence of dense breast tissue

If you think you may be at an increased risk for breast cancer, discuss this with your health care provider to see if you may benefit from additional testing or treatment to detect or decrease your risk of breast cancer.

Inherited mutations in breast cancer genes, such as BRCA1 and BRCA2, account for 5-10% of breast cancers. Women who have these genetic mutations are at an increased risk for the development of breast and certain other cancers. As a result, a more rigorous screening program should be implemented. Additionally, the option of preventative surgery should be discussed with a health care provider and/or genetic counselor.

Screening is an essential part of the fight against cancer. A yearly mammogram starting at the age of 40 can detect breast cancer early, when it is easier to treat and more likely to be cured. Please encourage the women in your life to follow these recommendations and get screened.