In this wildly unusual and challenging year, I am still reminded by the fact that women’s health remains at a critical juncture. We are embraced by the challenges of COVID-19 but we cannot forget the importance of screening tests and personal well being. The month of October has traditionally been Breast Cancer Awareness month, a reminder of the impact this disease has on the well-being and health of women worldwide. At the early start of my “blogging career,” breast cancer awareness was the first topic I reviewed and in the last year, I have come into contact with many opportunities to screen and diagnose patients.
It has been a tremendous revelation about how many women continue to take ownership of their health and the importance of screening. The challenge as a physician has been to calm any concerns a woman has “when she feels a lump in her breast” or even to discuss unwanted results with patients. Telling a young woman that she has breast cancer or a woman who has survived the hardships of cancer once, to then be ready to fight it again is never easy.
I want this blog to again give us an insight into the risk factors associated with breast cancer, the way we screen breast cancer, and how we as a community can empower our mothers, sisters, aunts, cousins, wives, etc to better reduce their risks.
The average woman’s lifetime risk for developing breast cancer is 1/8 (12%) and with improvements in screening (I.e. mammography), the survival rate over 5 years is 90%
What is important is knowing your personal medical history. Remember this includes medical problems, past surgeries, allergies, medications you are taking; the tricky part is gathering past medical history from family. Certain families, ancestries, and patient populations have genetic (or hereditary) risks. Most commonly seen are the #BRCA1 and #BRCA2 genes.
Risk factors that we consider include:
- Personal history of breast, ovarian, tubal, cancers
- Family history of breast, ovarian, tubal, or peritoneal cancer
- Ancestry (eg, Ashkenazi Jewish) with BRCA1 or 2 mutations
- Known carrier of a mutation
- Previous breast biopsy for high-risk lesion
- Radiation treatment to the chest between age 10 and age 30
The National Cancer Institute tell us that BRCA 1 and 2 mutations affect 4.5% of ALL breast cancer cases, and this 55-65 % is from BRCA 1 and 45% from BRCA 2!
Your doctor can use available assessment tools to help assess YOUR risk! You can even use the CDC checklist to help determine the risk! But it’s best to talk to your doctor who has more information.
Genetic Screening companies such as Invitae and Myriad have remarkable genetic screening tools to help identify genetic traits that put women at risk for breast cancer (and a host of other associated cancers or diseases). Genetic Counselors are an INVALUABLE resource for a better understanding of your risks.
Self Screening = self-awareness
The new recommendation is to encourage women to have awareness of the normal appearance and feel of their breasts, rather than doing frequent exams.
Physical Exam with your doctor
Clinical exams should be offered every 1-3 years for women 25-39 years old, and annually for women 40 years old or greater
It is recommended to perform this method of screening every 1-2 years.
Addressing some concerns:
Mammograms, like any screening tool, are not perfect
There are false positives with images, meaning you may need additional imaging or a biopsy to rule out malignancy. Women with dense breasts or those using hormone therapy may have an increased chance for false positive
For some women, the mammogram may be uncomfortable. But each woman has a different threshold
Dr. Niku! My doctor keeps mentioning BIRADS! What does BIRADS mean?
BIRADS = breast imaging reporting and data system
This is how radiologists interpret their findings and then send the reports to your primary care or OBGYN doctors.
|0—More information is needed. You may need another mammogram before a score can be given.
1—Nothing abnormal is seen. You should continue to have routine screening.
2—Benign conditions, such as cysts, are seen. You should continue to have routine screening.
3—Something is seen that probably is not cancer. A repeat mammogram should be done within 6 months.
4—Something is seen that is suspicious for cancer. You may need to have a biopsy.
5—Something is seen that is highly suggestive of cancer. You will need to have a biopsy.
A great start to help reduce your risk is to:
Eat a health diet
Maintain a healthy weight
Limit Alcohol Intake
If you have more questions, please ask me or your doctor! More information is available at:
#breastcancer #cancer #breastcancerawareness #cancerawareness #cancersucks #cancerfighter #breastcancersurvivor #cancerwarrior #pinkribbon #health #education #women #obgyn #brca #cancersupport #breastfeed #nosmoking #exercise #breastawareness #mammogram #genetics #genetic screening #dannynikumd