By Rachel P. Dultz, MD, FACS
Did the COVID-19 pandemic cause you to miss your regular screening mammogram?
If so, now is the time to get back on track.
Mammograms can detect cancer in its early stages when it is small and has not spread, making it easier to treat.
In fact, regular mammography screening substantially reduces the risk of dying from breast cancer, according to a recently released study sponsored by the American Cancer Society.
October is Breast Cancer Awareness Month, and what better way to celebrate than by calling your doctor to make your mammogram appointment and return to routine screening.
Second Leading Cause of Cancer Death in Women
After skin cancers, breast cancer is the most common cancer in American women. The American Cancer Society estimates that there will 281,550 new cases of invasive breast cancer diagnosed in women in the United States this year.
Moreover, the disease will result in 43,600 deaths, making it the second leading cause of cancer death in women, according to the American Cancer Society. Only lung cancer kills more women each year.
As the American Cancer Society also notes, since 2007, breast cancer death rates have been steady in women younger than 50 but have continued to decrease in older women.
These decreases are believed to be the result of finding breast cancer earlier through screening and increased awareness, as well as better treatments.
Today, there are more than 3.8 million breast cancer survivors in the United States, according to the American Cancer Society.
Gender and Age Biggest Risks
While men can also develop breast cancer, the disease is much more common in women, especially women aged 55 and older. Other risk factors, in addition to gender and age, include:
• Hereditary gene mutations.
• Having a family history of breast cancer.
• Personal history of breast cancer.
• Beginning menstruation at an early age.
• Entering menopause at a later age.
• Having a child late in life or never being pregnant.
• Undergoing post-menopausal hormone therapy.
• Drinking alcohol.
• Being overweight or obese after menopause.
• Not being physically active.
Be Aware of Changes
Any change in your breast, especially a new lump or mass, could be a sign of breast cancer and should be evaluated by your doctor. Other symptoms can include:
• Swelling of all or part of the breast (even if no lump is felt).
• Skin dimpling, often described as looking like an orange peel.
• Breast or nipple pain.
• Nipple retraction.
• Nipple or breast skin that is red, dry, flaking, or thickened.
• Nipple discharge, other than breast milk.
• Swollen lymph nodes under the arm or around the collarbone.
Many women with breast cancer have no symptoms, which is why screening mammograms are so important. Recommendations for how early mammograms should begin and how frequently you should be screened depends on your personal and family history, as well as your age.
The American Society of Breast Surgeons recommends:
• All women aged 25 and older should have a formal risk assessment for breast cancer.
• Women with an average risk of breast cancer should start annual screening mammograms at age 40.
• Women with a higher-than-average risk of breast cancer should start annual screening mammograms at an earlier age and should be offered additional imaging each year.
Several other medical organizations, including the American College of Radiology and the Society of Breast Imaging, also recommend starting annual screening mammograms at age 40.
Additionally, research shows that maintaining a schedule of regular mammograms, as recommended by your physician, can significantly reduce the risk of dying from the disease.
Advanced Diagnostic and Treatment Options Available
If the results of your mammogram suggest that you might have cancer, further imaging tests are generally recommended, and a biopsy is often necessary. A biopsy is the only way to know for sure if the abnormality is cancer.
Treatment for breast cancer varies from person-to-person and is increasingly more personalized and tailored to the specific cancer’s unique biological profile. No two cancers are treated the same. Some may require surgery, while others may be treated with targeted chemotherapy or radiation. Understanding the options as well as risks and benefits, is a critical step in the treatment process.
The Penn Medicine Princeton Health Breast Health Center offers 3D mammography services, and ultrasound guided and stereotactic breast biopsy. In addition to cutting-edge technology, the Breast Health Center provides the personalized services of breast health navigators, who help to guide patients after a breast cancer diagnosis.
The Center is designated a Breast Health Center of Excellence by the American College of Radiology and holds a three-year accreditation from the National Accreditation Program for Breast Centers, a program administered by the American College of Surgeons.
Though breast cancer may not be able to be prevented, there are certain steps you can take to help lower your risk and protect your health overall.
• Maintain a healthy weight. Weight gain has been linked to a higher risk of breast cancer after menopause.
• Be physically active. The American Cancer Society recommends adults get at least 150 to 300 minutes of moderately intense exercise or 75 to 150 minutes of vigorously intense physical activity each week to lower breast cancer risk.
• Avoid or limit alcohol. As the American Cancer Society notes, it is best not to drink alcohol. For women who do drink, they should have no more than one alcoholic drink a day.
• Go for annual check-ups and screenings. In addition to your regular mammogram, be sure to go for an annual check-up with your doctor who can help identify your risks for breast cancer and other diseases and recommend screenings.
• Get vaccinated. Though it can’t prevent cancer, the COVID-19 vaccine, in addition to vaccines for viruses such as the flu, shingles, and pneumonia, can help keep you healthy and strong overall.
To find a physician with Penn Medicine Princeton Health, call 888-742-7496 or visit www.princetonhcs.org.
Rachel P. Dultz MD, FACS, is a fellowship trained breast surgical oncologist and board-certified surgeon as well as a fellow of the American College of Surgeons. She is the medical director of the Breast Health Center at Penn Medicine Princeton Medical Center.