Taking Advantages Of Early Detection

Since National Breast Cancer Awareness Month (NBCAM) began in 1985, mammography rates have more than doubled for women age 50 and older and, as a result, breast cancer deaths have declined. While this is good news, there are still women who do not take advantage of early detection at all and others who do not get screening mammograms and clinical breast exams at regular intervals. The purpose of this nationwide campaign is, therefore, to increase awareness about the importance of the early detection of breast cancer.
The Medical Society of the State of New York (MSSNY) believes that regular physical examinations, mammography (an x-ray picture of the breast) and knowledge about breast cancer are imperative to protecting health. MSSNY is, therefore, joining the NBCAM organization in passing along the following information.

Risk Factors for Breast Cancer
Breast cancer is the most common cancer diagnosed in women in America. Scientists have found that the most common risk factors include:
*Age - The risk of breast cancer increases as a woman grows older.
*Personal history & family medical history - Women who have had breast cancer and women with a history of breast disease (not just cancer, but a condition that may predispose them to cancer) may develop it again. The risk of getting breast cancer increases for a woman whose mother, sister, daughter, or two or more close relatives have had the disease.
*Genetic alterations - Some individuals, both women and men, may be born with an “alteration” (or change) in one of two genes that are important for regulating breast cell growth. Scientists estimate that only about 5-10 percent of all breast cancers are due to genetic changes. One out of two women with these changes will likely develop breast cancer. People with a family history of breast cancer are encouraged to undergo genetic testing.
*Reproductive history - Starting menses at an early age and/or having a first pregnancy after age 25 to 35 or having no children.
*Use of Hormone Replacement Therapy (HRT) - Based on the Women’s Health Initiative Study (2002), women appear to have an increased risk of breast cancer while they are on HRT and a short time thereafter, compared to those who have never used postmenopausal HRT. This is based on a study of 16,000 healthy postmenopausal women aged 50 to 79 who were taking estrogen plus progestin as HRT or a placebo (an inactive pill).
*Certain lifestyle choices - Common to everyone are daily lifestyle decisions that may affect breast cancer risk. These day-to-day choices involve factors such as poor diet, insufficient physical activity, alcohol use and smoking. Besides possibly reducing breast cancer risk, lifestyle improvements represent smart steps for a healthier life, since they can help prevent heart disease, diabetes, and many other chronic, life-threatening conditions.

Barriers to Testing
Studies have identified a number of barriers to mammography screening. Some can be overcome with health education; others require programs to make mammography more accessible for women. The top four barriers are: waiting for a physician recommendation rather than being proactive and asking for one, not thinking about the importance of mammography and early detection of breast cancer, assuming mammography is not needed if no breast problems exist, and simply not prioritizing and making the time.
Other barriers include: fear of experiencing pain from the procedure; fear of receiving a breast cancer diagnosis; concerns about screening costs and the financial burden of diagnostic procedures and treatment, if needed; not having had a recent clinical breast exam or Pap test; not having a routine source of healthcare; not having the time to take off from work to be screened; and living a far distance from the screening site.
Importance of Early Detection
When breast cancer is detected early and treated promptly, suffering and, ultimately, the loss of life can be significantly reduced. Women - and men at high risk for breast cancer - are encouraged to ask their physicians and other health care providers about mammography screening. Mammography is the single most effective method to detect breast changes that may be due to cancer, long before physical symptoms can be seen or felt, For most women, high quality mammography screening should begin at age 40. As risk factors vary, everyone should discuss the plan that is right for them with their physician. If breast cancer is detected in its early stages, there are more treatment options, treatment can be less disfiguring and less toxic, and survival is improved.

Breast Cancer Treatment
When breast cancer is detected at an early stage of development, a number of effective treatment options are available. A woman and her physician will choose the treatment that is right for her, based on the location and extent of the cancer, her age and preferences, and the risks and benefits of each treatment. The basic treatment choices for breast cancer are surgery, radiation, chemotherapy, and hormonal therapy. Local treatments - such as breast surgery and radiation therapy - are focused on the breast itself to remove or destroy the cancer cells confined to the breast. Systemic treatments - such as chemotherapy and hormonal therapy - aim to destroy the cancer cells that may have spread throughout the body.
This information is provided by the Medical Society of the State of New York (MSSNY).