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Breast Cancer Awareness

October is National Breast Cancer Awareness Month, an annual campaign to help strengthen the work of standing together against breast cancer. Organized by major breast cancer organizations across the country, the campaign increases awareness of the disease and raises funds to help save lives through ground-breaking research and early-detection screening. 

The American Cancer Society’s Breast Cancer Facts & Figures 2022-2024 report gives the following overview of breast cancer. 

  • Breast cancer is a group of diseases in which breast tissue cells divide uncontrolled and typically result in a lump or mass.
  • Early stages of breast cancer generally do not have symptoms. Breast cancer screening is important for early detection when a tumor is small and most easily treatable. 
  • A painless lump is a common physical sign of breast cancer. Sometimes the cancer can spread to nearby lymph nodes under the arm. Less common symptoms of breast cancer include breast pain or heaviness and swelling, dimpling, thickening or redness of breast skin. Nipple changes including a discharge, retraction or scaly skin can also be signs of breast cancer. Any woman or man with a persistent change in a breast should be evaluated by a physician. 

Think Family Medicine physician Erika Rothgeb, MD, lends further insights here on the importance of breast cancer screening and support.  

How prevalent is breast cancer in the United States?

Breast cancer still affects one in eight women, whether or not a woman has a family history of breast cancer. Breast cancer still can affect men although much less commonly. In the United States, one out of every 100 breast cancer diagnoses are for men. The big message is it can happen to you. Even if you’ve never had a problem mammogram or there’s no family history, screening is still important because 12% of all women will be diagnosed with breast cancer in their lifetime.

Why are regular mammograms important?

While an individual mammogram is not the ultimate cancer-detecting test in itself, mammograms done year after year after are the most useful because we can compare the breast tissue for changes over time. Every time somebody gets a mammogram, we look at previous mammograms and determine if there’s any change in the architecture of calcifications or masses. If we have 10 years’ worth of mammograms to look at, we can start to find smaller nuances of changes that have occurred rather than relying on a single test. Mammograms become more useful the more times they’re completed.

What are hesitancies about getting mammograms?

Some of the hesitancy is discomfort. Mammograms are not a comfortable exam, but you can take medications ahead of time and the screening can be life-saving. Another hesitancy is that an individual mammogram by itself is not always the best test for breast cancer. Some mammograms show up as false negatives or false positives. Mammograms are not 100% fail safe. In addition, some women are called back for ultrasounds, mammograms and even biopsies who end up not having breast cancer. This can lull women into a type of testing fatigue and they may think it’s not important to keep screening. 

How effective are routine breast exams by a healthcare provider?

Studies have shown that medical providers are not better at finding cancers than patients are. Clinical breast exams done routinely have somewhat fallen out of favor. Yet if there is a concern, we will do a breast exam and determine if anything feels suspicious. If we find a possible lesion, we will order a  mammogram and/or an ultrasound as the next best diagnostic step. 

As far as women doing their own breast exams, current medical findings show that for the average-risk woman—someone without increased risk for developing breast cancer—self exams are not recommended because breast tissue is lumpy and it can be difficult to discern what is healthy tissue and what is not. Screening mammograms are a vital way to stay proactive with breast health. 

What puts women at higher risk for breast cancer?

It is important to determine a woman’s individual risk of breast cancer. Common risk factors include a personal history of cancer and a family history of cancer, particularly breast or ovarian cancer. Women who started their menstrual cycle younger, or experienced delayed childbearing or who have never given birth are at a higher risk for breast cancer. Using hormone replacement therapy is a risk factor as well as being of Ashkenazi Jewish heritage. As a woman increases in age, she is more likely to get breast cancer not less likely. I use a risk factor model with my patients who have a family history to help determine their lifetime risk. If a woman is at an increased lifetime risk, we discuss doing additional imaging.

When should a woman start getting mammograms?

In general, major cancer guidelines for the average-risk woman recommend starting annual mammograms between the ages of 40 and 50. If there is an increased lifetime risk for breast cancer, we discuss with patients to start at age 35. There is some debate for starting high-risk women as early as age 30. 

Is there an age when women no longer need mammograms?

Some women may reason that they do not need mammograms once they’ve reached age 55 or have gone through menopause, but breast cancer increases with age. For women aged 55 to 74 years with average risk for breast cancer, there may be the option to do a breast cancer screening every other year. Decreasing the frequency of mammograms depends on an older woman’s personal risk and personal health history. 

How does a family history of cancer affect breast cancer risk?

A personal or family history of breast or ovarian cancer plays a significant part in increased risk for breast cancer. Ovarian cancer is a big risk cancer in the models we use to determine a woman’s lifetime risk. We also know that colon cancer and prostate cancer tend to run in the same group as breast cancer. Some genetic mutations that cause cancer tend to run together. Any cancer history in a family is important to know. If there is a family history of cancer, the question is how many family members and how young were they on onset of their cancer. 

It takes about five minutes for us to run our risk calculator to know if a patient is at increased risk for breast cancer. I can’t stress enough for women to talk with their think physician to determine personal risk for breast cancer and not try to guess their personal risk themselves. Unless we run the models and ask the questions, we’ll never know who is at high risk and who is not. The conversation is very important whether we proceed with additional imaging or not. 

What type of mammography does think offer?

Think offers 3D mammograms for both breast screenings and diagnostic testing. The 3D mammograms work with both regular breast tissue and implants and provides real-time feedback for our on-site radiologist. In the ever-changing landscape of healthcare, our think providers stay updated with medical researchers, statisticians and experts in the medical community. These teams are continually looking at literature and doing studies to determine what is the best thing to do for the breast and how to keep breast tissue healthy. Breast cancer guidelines you may have been told 10 years ago might be different today, so it’s important to stay current with your medical provider for your own personal health needs. At think, we make sure the advice we give is up to date and reflects the best possible care options for our patients. 

Do men need breast cancer screening?

There is still some stigma that only women get breast cancer and that is not true. If men have symptoms such as the breast tissue getting larger on one side or any skin or nipple changes, it would be important to know. Or if there is a strong family history or genetic mutation such as the BRCA mutation, then we recommend men do self-exams and follow up with their provider. Breast cancer can happen with men, but the vast majority of breast cancers are found in women. Thankfully, breast cancer is much less common in men, however, it can be quite deadly too. This is especially true because men might not seek treatment right away. 

What overall advice would you give about breast cancer awareness?

The best advice I give people is listen to your body. If you notice a bump or your partner notices something that didn’t feel like it was there before, make an appointment with your physician. If you notice a nipple has a discharge or the nipples are retracting or you notice skin changes on the breast, you need to check in with your healthcare provider. Breast cancer is not just about lumps inside the breast. How the breast looks on the outside is important too. If you notice something that doesn’t seem right, then come in and we’ll take a look and we’ll talk and determine if we need to do some additional imaging to ensure that everything looks healthy. 

What are newer treatments for breast cancer?

The treatments that we have today are not necessarily the treatments that we have used in previous years. If you’ve been diagnosed with breast cancer, the advances in treatments mean you do not necessarily need a mastectomy. Most women do just fine with a lumpectomy and the outcome is just as good. The cancer surgeries today are much easier to recover from and they have fewer cosmetic issues down the line. Also, not every woman needs chemo for breast cancer. This is why mammograms are so important because they can find cancers when they’re smaller and easier to treat. The goal always is to find the problem as early as we possibly can.

How is Think Whole Person Healthcare most beneficial to breast cancer patients?

If we do find breast cancer in a patient, our think medical team wants to make sure there is seamless and convenient care for the patient. Think partners with the Nebraska Cancer Specialists who have a clinic in the think building so the cancer specialists can work closely with our Primary Care physicians. We have excellent healthcare options in Omaha for both oncologists and surgeons. Think works closely with all of the major hospital groups in the area. We want to do what’s best for each individual patient.

Stay current with your breast health by scheduling a consultation or mammogram today. Think Whole Person Healthcare is devoted to treating the whole person while delivering the highest quality at the lowest cost possible. To schedule a mammogram or book a provider appointment, call 402-506-9000,  or schedule an appointment online. Think Whole Person Healthcare, conveniently located in central Omaha, can provide same-day appointments.   

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