Breast Cancer - Questions & Answers
Q
Who is at greatest risk of being diagnosed with breast cancer?
A
Age:
Increasing age is the strongest risk factor for developing breast cancer, 76.8% of all breast cancers are detected in women age 50 and older. Breast cancer is rare in younger women, with an incidence rate of only one case per 100,000 for women ages 20-24. However, the rate climbs to 25.0 cases for women ages 30-34, 121.7 for women 40-44, and 244.8 for women 50-54.3 Although heart disease is the leading cause of death in women in the United States, breast cancer is the leading cause of cancer death in women between the ages of 15 and 54.
Family History:
After age, the strongest risk factor for being diagnosed with breast cancer is having a mother, sister, or dauther who has had a breast cancer.
Race:
For all ages combined, white women are more likely to develop breast cancer than African-American women. In 1994, the incidence rate for white women was 112.8 cases per 100,000 and for African-American women, 100. Among women younger than 50 years of age, African-American women are more likely to develop breast cancer than white women. In 1994, African-American women were more likely to die of breast cancer (31.3 per 100,000) than white women (25.2 per 100,000). Breast cancer incidence and mortality rates vary among racial and ethnic groups. Between 1988 and 1992, white, African-American, and Hawaiian women had the highest rates of breast cancer incidence and mortality.4 Among different Asian populations, incidence rates ranged from 28.5 per 100,000 for Korean women to 105.6 per 100,000 for Hawaiian women, and mortality rates ranged from 11.2 per 100,000 for Chinese women to 25.0 per 100,000 for Hawaiian women.
It is estimated that more than 1.8 million women will be diagnosed with breast cancer in the 1990s. Early detection through breast self-examination, clinical breast exam and screening mammography could save the lives of these women.
Q
What is the chance of a woman being diagnosed with invasive breast cancer in the next 10 years?
A
From birth until age 90 the chance of being diagnosed with breast cancer is 1 in 8.
The chance of breast getting breast cancer increases as women get older:
the chance that 30 year old woman will be diagnosed with invasive breast cancer in the next 10 years about 1 in 250
40 yr old - 1 in 70
50 yr old - 1 in 40
60 yr old - 1 in 30
Q
What is the chance of dying of breast cancer?
A
The chance that any 30 year old woman will die of invasive breast cancer in the next 10 years is about 1 of every 1000 women,
40 yr old - 1 in 300
50 yr old - 1 in 150
60 yr old - 1 in 100
Q
How important is early detection?
A
Although breast cancer is a very serious, potentially fatal disease, it has a very high cure rate in its early stages. In fact, with early detection, breast cancer patients have a 95 percent chance of survival.
By performing monthly self-exams, you become familiar with the normal shape of your breasts - increasing the chance that you'll discover a suspicious lump. In addition to lumps, other warning signs to look for include: inverted nipple, skin swelling, nipple discharge, superficial veins or skin dimpling.
Performed by a qualified health professional, a physical exam involves a thorough inspection of your breasts, chest and underarms. Most doctors recommend a physical exam at least every three years between ages 20 and 40. After age 40, the frequency increases to annually.
Q
How is breast cancer usually discovered?
A
Breast cancer is detected by a woman discovering a lump in her breast, by clinical breast exam by a doctor or nurse, or by mammograms.
Q
What is a mammogram?
A
A mammogram is an x-ray of the breast. A screening mammograms are performed on a routine basis on women to detect breast cancer when it is small, before it can be found by a woman or her doctor. Each breast is x-rayed from the side and from the top. Your breasts are pressed between two pieces of plastic just enough so breast tissue can best be seen on the mammogram. Pressing your breasts for a few seconds is not harmful and minimizes the necessary x-ray dose
The radiologist looks for any abnormality that may indicate an early sign of breast cancer. Mammography has the ability to detect breast cancer two years before it reaches the size that can be felt in the breast. A diagnostic mammogram is used to evaluate a woman with a breast problem/symptom or an abnormal finding on a screening mammogram. it should be performed under the direct, on-site supervision of a board certified radiologist.
Q
Are mammograms painful?
A
Pressing the breast between two pieces of plastic for the mammogram may be uncomfortable. Some women say having a mammogram is quite painful, but most say there is only brief discomfort that last seconds.
Q
Are mammograms safe?
A
Yes. Experts agree that the amount of radiation exposure during mammography is minimal and about the same as receiving a dental x-ray. It has been estimated that if 10,000 women have yearly mammograms for ten years, the radiation from mammograms will cause 1 additional breast cancer death.
Q
How long does it take to get the results of a mammogram?
A
You should receive the results within 10 days of your mammogram, if not, call your doctor or the mammography facility.
Q
What happens if I have an abnormal mammogram result?
A
If you have an abnormal mammogram result, you will need to have some further test(s) and you may need to see a surgeon. The diagnostic tests that are done to find out if the abnormal area on your mammogram is cancer may include one or more of the following:
Physical examination:
Examination of your breasts might be done by your doctor or a breast surgeon to find out if there is a lump in the area where the mammogram is abnormal.
Diagnostic mammogram:
Special mammograms that magnify the breast image might be done to better see abnormal spots in the breast.
Ultrasound test:
Sound waves might be used to look at abnormal spots to see if there is a cyst that contains fluid.
Needle aspiration:
A long needle might be used to remove fluid and cells from the area of the breast that has the abnormal spot. The cells are then examined to see if there is cancer. This test is usually done under local anesthesia.
Surgical biopsy:
A part or all the area of the breast that has the abnormality might be removed. If there is not a lump in the area of the breast where the mammogram is abnormal, mammograms are first performed to show the surgeon where the abnormal area of the breast is located, and then needles are placed in that breast area. When the needles are in place, the surgeon removes the breast tissue that was abnormal on the mammogram. This test can be done under local or general anesthesia. Biopsies usually leave a scar.
Q
What are the benefits of mammograms?
A
Mammograms can detect some breast cancers when they are small, before they have spread and become incurable. Treatment for breast cancer is more effective if breast cancer is found when it is small and localized. There are differences in the benefits of mammograms according to age.
Women 50 to 69 years old:
There is good evidence that mammograms decrease deaths from breast cancer in women aged 50 to 69 years if breast cancer is adequately treated after discovery by a mammogram. Studies found fewer breast cancer deaths in women aged 50 to 69 years who received routine mammograms compared to women who did not receive routine mammograms.
Among 10,000 women 50 years old, 260 will die of breast cancer in the next 20 years. If all 10,000 women get routine mammograms over the next 20 years, 37 breast cancer deaths may be prevented. This means for women aged 50 and older, mammograms prevent one breast cancer death for every 270 women screened regularly for 20 years.
Women 40 to 49:
There is some evidence that mammograms may decrease deaths from breast cancer in women in their forties. In studies involving thousands of women, there were fewer deaths from breast cancer in those who got routine mammograms than in those who did not, but this benefit only appeared ten years after screening began.
Among 10,000 women 40 years old, 37 will die of breast cancer in the next 10 years. If all 10,000 women get routine mammograms over the next 10 years, 4 breast cancer deaths may be prevented. This means for women in their forties, mammograms prevent one breast cancer death for every 2,500 women screened regularly for 10 years.
Q
Why are mammograms more beneficial in women aged 50 and older than women under age 50?
A
The answer to this question is not clear. It may be because younger women more commonly have dense breast tissue that can hide breast cancer and make it hard for mammograms to detect. Or it might be because breast cancer in young women tends to grow more quickly and spread early so that mammograms don't find the breast cancer until after it has spread and become incurable. Also, since breast cancer is less common in younger women, there are fewer potential breast cancer deaths to prevent.
Q
What are the breast-cancer clues women are most likely to miss?
A
The areas around the nipple and in the armpit are most commonly missed during a breast self examination.
What is my best defense?
Q
What is my best defense?
A
Many exciting advances are being made in the field of breast cancer research. In the future, medical science may be able to prevent breast cancer. Until then, early detection is your best defense against the disease. Breast cancer deaths could be decreased by 30 percent if all women 50 years and older followed the mammography screening guidelines.
Q
What is a Breast Self Exam (BSE)?
A
Since breast problems can develop between clinical breast exams or between mammograms, BSE can help you to detect any changes from the normal look or feel of your breasts. BSE is a technique performed at the same time each month, preferably just as your menstrual period is ending. begin BSE by age 20, and continue BSE monthly, throughout your life.
Q
What should I do if I have a breast problem?
A
If you notice any change in how your breasts normally look or feel, don't panic but do see your health care professional who will obtain a medical history, examine your breasts and suggest what further action needs to be taken.
Further action may include re-examination, a dignostic mammogram, ultrasound, cyst aspiration, and/or referral to a surgeon. Ultrasound (sonogram) is used to differentiate between a solid or fluid filled lump (cyst). Cyst aspiration uses a small needle to withdraw the fluid from the lump.