Twelve percent of women today will develop invasive breast cancer, and more than 40,000 will die from it this year alone. That’s why a refresher course on early detection and staying up-to-date on the latest studies is essential and the reason for Breast Cancer Awareness Month each October.

Risk factors

There are several risk factors for breast cancer, as identified by the American Cancer Society (ACS). Some factors that are unchangeable include female gender, aging, genetics, and race and ethnicity (white women are at slightly higher risk). A greater number of menstrual cycles, previous chest radiation, and exposure to the drug diethylstilbestrol (DES) also puts women at a slightly higher risk.

In contrast, according to the National Cancer Institute (NCI), women who had more than one child have increased protection with each successive birth. Women who breastfed also reduced the risk of breast cancer. The longer the total length of time spent breastfeeding during the child-rearing years, the greater the protection.

Having one daily alcoholic drink increases the risk only slightly, while the greater the consumption, the higher the risk. More than five drinks daily increase the risk for other cancers as well.

After menopause, being overweight or obese increases risk. But it’s a bit more complicated than just weight. Waist area fat, in particular, might be more significant in increasing risk than fat in other parts of the body such as hips and thighs.

Exercise, however, has been shown to decrease risk, according to a study by the Women’s Health Initiative. It found just 1.25 to 2.5 hours of brisk walking each week can reduce risk by 18 percent.

Several factors that previously have been claimed to increase risk factors are now disproven or deemed highly improbable, according to ACS. These include antiperspirants, bras, abortion or miscarriage, dense breasts, fibrocystic disease, and breast implants.

Symptoms

If you notice any of these symptoms, see your health care provider to rule out breast cancer. Symptoms to watch for include:

• A new lump or breast change that feels different from the rest of your breast

• A new lump or breast change that feels different from your other breast

• You feel something different that you haven’t felt previously

• Thickening, a lump or hard knot inside the breast or in the underarm area

• Breast swelling, warmth or redness

• Change in breast shape or size

• Breast skin dimpling or puckering

• A sore or rash on the nipple, particularly scaly or itchy

• Your nipple or other parts of your breast pulling inward

• Sudden nipple discharge

• Pain in one spot that doesn’t go away

Early detection and screenings

Screenings are an essential means for detecting breast cancer, hopefully in its early stages.

Until recently, women were encouraged to do a monthly self-examination. But a major study reported in The Journal of the National Cancer Institute in 2002 concluded self-examination has played no role in improving cancer detection. It also found the extensive teaching of self-examination leads to an increased rate of benign breast biopsies.

Clinical breast exams, however, are still recommended. Beginning at age 40, clinical exams should be done annually. Women with higher risk factors should have exams more often and consult with their doctor for the recommended frequency.

Mammography, believed to be one of the most crucial tools in early detection for decades, first started in the 1960s. Early trials found mammography reduced breast cancer death rates by 25 percent. But medical experts now believe much-improved treatments likely played a more significant role in reducing deaths.

For this reason, mammograms have come under fire in recent years as more studies have revealed the debatable usefulness of this screening technique, at least for younger women. That’s because breast cancer and detection are more complex than once understood.

It’s now known there are at least four types and subtypes of breast cancer. Mammography often doesn’t detect the more lethal types until they’re in the later stages. Mammograms also result in significant overdiagnosis leading to unnecessary treatment, which comes with its own risks.

Dr. Deanna Attai, president of the American Society of Breast Surgeons, explained, “Ductal carcinoma in-situ (DCIS) is also referred to as noninvasive or Stage 0 breast cancer. It is primarily diagnosed by screening mammograms, as it often does not form a palpable lump. DCIS accounts for approximately 20 percent of mammographically detected breast cancers. As screening mammography has become more prevalent, the rate of DCIS detection has increased.”

Some medical experts say DCIS is really not a form of cancer at all, and referring to it as such results in overly aggressive treatment. The likelihood of low-grade DCIS developing into invasive breast cancer is only 16 percent, said Dr. Attai. In contrast, high-grade DCIS has a 60 percent chance over 10 years. The problem is there’s currently no way to determine which cases of DCIS will ultimately develop into breast cancer.

Still, breast cancer is the second leading cause of cancer deaths among women in the U.S. Various studies revealed mammography screening is most useful for those in the 50-69 age group.

The latest cancer screening guideline by the ACS recommends women with average risk should begin regular mammography screenings at age 45. Then they should be annually screened until they reach 54. After that, they should transition to every two years, as long as they’re in good health.

Finally, there’s no one-size-fits-all plan that works best. So, mammography screening for breast cancer should be based on informed decisions and individualized plans. It should take into account a woman’s age, risk factors and both the advantages and disadvantages of mammography for each woman’s unique circumstances. 

To see if you’re eligible for free breast cancer screenings, call:

Grand Junction Marillac Health: 970-200-1600, www.marillachealth.org

Delta County Health: 970-874-2183

Montrose Memorial Hospital: 970-252-2893, www.montrosehospital.com