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Breast Cancer: Prevention And Detection

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Breast Cancer: Prevention And Detection
June 18
22:00 2016

GET TO KNOW THE WAYS YOU CAN PROTECT YOURSELF

What’s your risk factor?

While breast cancer most often shows up unexpectedly, understanding your risk factors for the disease can improve your chances of catching it early on and having successful treatment. Where your risk lies depends on things you can and cannot change. As a woman ages, the chances of having breast cancer increases, which is why it’s important to stay aware and take the necessary precautions to protect yourself.

Here’s a list of some of the risks you should be aware of based on the Canadian Breast Cancer Foundation (CBCF):

RISKS:

  • Carrying a genetic mutation (can find this out through genetic testing)
  • Undergone chest radiation for Hodgkin’s lymphoma
  • Family history of a first-degree relative having breast cancer

“That risk would be higher if that first degree relative developed breast cancer younger, premenopausally. It would be greater if that family member had breast cancer in both breasts. The risk goes up if you have multiple relatives, especially first degree, and then multiple generations.” – Dr. Paula Gordon, breast cancer radiologist and medical director at BC Women’s Hospital Breast Health Program.

Increased exposure to estrogen from:

  • Starting period younger
  • Starting menopause later
  • Lengthy hormone therapy
  • High body weight
  • Fertility treatments
  • Alcohol consumption
  • Smoking

What can you do to minimize your risk?

You can’t choose your relatives, but there are a few things you can do:

  1. Minimize alcohol intake. There is no “safe” amount. The more alcohol a woman consumes, the higher the risk of getting breast cancer.
  2. Exercise! Numerous studies have shown that women who exercise moderately have a lower risk of getting breast cancer than sedentary women.
  3. Maintain a healthy body weight. Women who are overweight, especially after menopause, are at a higher risk of getting breast cancer than women who are a healthy weight.
  4. If you need hormone therapy for menopausal symptoms, take the lowest possible dose for the shortest possible time.
  5. Quit smoking. This is good not just for your breast cancer risk, but for your heart, lungs and brain.
Breast Cancer: Prevention And Detection

Breast Cancer: Prevention And Detection

Early detection

There are different methods that can help you detect a sign of breast cancer early on. One you can do yourself is self-examination. Dr. Gordon explained that while women may get anxious to self-exam and worry about finding a lump, it’s an important step a woman should take. Dr. Gordon recommends doing self-examining following a menstrual period, because for most women, the breasts are softer, less tender and less lumpy then. Knowing what your own normal feels like makes it easier to detect an abnormal lump. Dr. Gordon explained that this will not only save unnecessary trips to the doctor, but ensures getting diagnostic tests when they are needed.

Women over 30 with a breast lump can be referred to get a mammogram and/or an ultrasound. According to CBCF, Canada experienced a 42 per cent decrease in breast cancer deaths between 1986 to 2013, largely due to

“earlier detection through regular mammography screening, advances in screening technology and improved treatments.” Dr. Gordon described a mammogram as a “low-dose x-ray of the breast,” which can show possible abnormalities, such as a tumour. The breast is compressed by the machine in order to spread out the tissue, which increases the chances that a cancer will be seen if it’s there.

Two pictures are taken of each breast, one with the breast “compressed from top to bottom,” and the other – “compressed side-to-side at an angle.” The mammogram will then be read by a radiologist, who will check for any possibility of a cancer.

There are two types of mammograms: diagnostic and screening. A diagnostic mammogram is done for women who have a lump or other problem, who’ve had an abnormal screening mammogram or for women who’ve had breast cancer and are having an annual checkup. If there is a lump, during the test, a technologist will sometimes tape a marker on the skin where the lump is located, which will be visible on the mammogram. Women with breast implants also have diagnostic mammograms. Since implants cover up much of the breast tissue, four pictures are taken of each breast, two of which include the implant to make sure the implant is okay and to see the tissue around the implant, and two with the implant pushed back, to get a better look at the tissue in front of the implant.

“The technologist is usually able to feel where the implant starts, and she’s able to pull the patient’s native breast tissue forward off the implant, push the implant out of the picture, and then compress just the breast tissue,” explained Dr. Gordon.

A screening mammogram on the other hand, is used for early diagnosis and is for women who do not have signs of breast cancer. According to CBCF, once a woman is a certain age, she becomes eligible for a free biannual screening mammogram. The age varies among provinces, with Ontario starting at age 50, while British Columbia starts at age 40. While some provinces end the coverage at 69, others end it at 74. CBCF claims that in 2014, an estimated 82% of new breast cancer cases in Canada will occur in women over the age of 50. If a woman requires a mammogram outside the province’s age range, a doctor’s referral will be required. Women at very high risk, such as those with a mutation of the cancer gene, are eligible for annual screenings between the ages of 30 to 69, and are advised to do an MRI every year as well.

Supplementary imaging tests may sometimes be required in addition to a mammogram, especially if a radiologist notices something that could be abnormal, or if a woman has a lump. According to Dr. Gordon, mammograms are around 80 per cent accurate.. Dr. Gordon mentioned that the biggest influence on the accuracy of results is breast density. She explained that every woman’s breasts are made up of fat, glandular tissue and fibrous tissue. On a mammogram, fat is black while normal glandular tissue is white. Lumps also appear white, which makes it more difficult to see cancers in dense breasts, but easier with more fatty breasts.

Breast Cancer: Prevention And Detection

Breast Cancer: Prevention And Detection

“If a woman’s breasts are totally fatty and black, even the smallest white cancer is going to jump at us and be easy to see. If a woman’s breasts are fat and dense, we’ll still be able to see the cancer if it’s outlined by fat. But if a cancer is surrounded by normal white tissue, we might not be able to see it on the mammogram,” stated Dr. Gordon, mentioning that a negative result on a fatty breast will be almost 100 percent accurate, while a negative result on a dense breast could still hide a cancer.

Women may also need additional testing because of a false-positive result, since according to Dr. Gordon, everything from cysts, non-cancerous tumours and scar tissue from a previous surgery can show up on a mammogram. Requiring additional testing can be a scary, but Dr. Gordon explained that most women called back for extra tests do not have cancer.

Women need to know that after they are called back after mammogram, they shouldn’t panic.

“It doesn’t mean you have cancer. It means the radiologist is being cautious and wants to do some more tests to make sure you don’t have cancer.”

The next steps…

If a lump is found, even if it not suspicious for cancer, often a needle biopsy will be the next step. If the needle biopsy is negative, then the woman may not need surgery. Even if the lump is very suspicious for cancer, a needle biopsy is an important step. According to Dr. Gordon “the surgeon wants to know as much about the patient before they do their surgery,” and if the biopsy reveals there’s a cancer, it can also show what type of cancer it is and how aggressive it is.

After local freezing, dull pressure may be felt during the needle biopsy, but no pain. There are different ways a needle biopsy can be performed. If there is a feelable lump, the patient’s doctor can do the biopsy in the office without any imaging-guidance. Otherwise, imaging guidance will be required. Whether an ultrasound, MRI or mammogram is used to guide the needle will depend on which test the lump was detected, and which guidance is best for the patient.

Needle biopsies have played a big role in preventing unnecessary surgeries, while also prompting life-saving surgeries. If a cancer diagnosis is received, the patient will then be referred to the correct specialist depending on the size of the cancer. By going through the necessary screening measures, the breast cancer can be caught early and chances of beating the disease can drastically improve.


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1 Comment

  1. tammy tumul August 13, 20:53

    i don’t get it women should check and put alll the religious reservation behind and go get checked

    Reply to this comment

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