Helping You Understand Breast Cancer and the New Breast Cancer Screening Guidelines Recommendations

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Helping You Understand Breast Cancer and
the New Breast Cancer Screening Guideline Recommendations (11/2009)

"Breast cancer." It's a word that no woman ever wants to hear.

When you are faced with a diagnosis as grave as cancer, nothing but fear and anxiety, and perhaps numbness, rushes through your body. It feels like the rooming is spinning around you; everything feels out of control. The world is not as it was before. You have no clue what your next step is. You can't see yourself five years, ten years from now. Fear clouds everything. All you can think of are your love ones, your husband, your partner, your family members, and your children.

"Will I survive? What is the cure rate, doctor? What are my treatment options?"

According to the American Cancer Society, an estimated 192,370 new cases of invasive breast cancer will be diagnosed in the United States before 2009 is out. In 2009 alone, around 40,170 people will die from breast cancer, and another 62,280 will struggle to beat breast cancer in situ (cancer that is confined within the ducts or lobules).

Excluding skin cancer, breast cancer is the most common cancer among American women, making up nearly 1 in 4 cancers diagnosed. Although men can also develop breast cancer, they are at low risk.

Breast cancer is the second leading cause of death in women, after lung cancer. If you are a woman, your chance of having invasive breast cancer at some point in your life is less than 1 in 8! Your risk of dying from breast cancer is around 1 in 35.

Breast cancer death rates tend to increase with age. Between 2002 and 2006, 95 percent of new breast cancer diagnosis and 97 percent of breast cancer deaths happened in women over the age of 40.

The 5-year survival rate is slightly lower among breast cancer patients under age 40 (83 percent) compared to those who are 40 and older (90 percent). This may be due to these cancers in the younger women being more aggressive and less responsive to treatment.

These statistics may be scary, but perk up. In the United States, there are currently over 2.5 million breast cancer survivors.

Because breast cancer is such a prevalent disease, it is a well-researched disease and you have many treatment options. The death rate from breast cancer has been decreasing in recent years possibly due to early detection and more effective treatment options.

Your treatments will vary depending on your stage of cancer and how advanced your disease is when it is diagnosed. You may undergo chemotherapy, radiation therapy, surgery, hormone therapy, targeted therapy (the use of drugs and other substances to attack cancer cells while doing little harm to your health cells), and bone marrow and blood stem cell transplant.

In its earliest form, stage 1 breast cancer, you have a 100 percent 5-year relative survival rate. In stage 2, the rate goes down to 86 percent. Stage 3 is at 57 percent, and stage 4 is 20 percent 5-year relative survival.

That's why it is vital that you catch breast cancer early. The earlier the stage, your cancer is localized in one spot, making it easier to treat. But once breast cancer is in its advanced stage, it can spread to other parts of your body—including your lymph nodes, liver, lungs, and even brain. These become harder to treat.

In its very early stages, breast cancer can produce no symptoms. It is often painless, and you may not realize you have cancer until you discover a hard lump on your breast.

Healthcare professionals want to catch breast cancer early, before any symptoms appear. They use screening exams, such as mammograms and clinical breast exams, to do this. For years, doctors have also recommended that you start doing breast self-exams starting in your 20s. This may also help you notice changes in your breasts, and lead to early diagnoses.

Early detection can lead to a better treatment options, including less aggressive surgery and adjuvant therapy (such as chemotherapy and radiation therapy).

The American Cancer Society and the American College of Obstetrics and Gynecologists maintain that women over the age of 40 should have regular mammograms.

A mammogram is a low-dose x-ray procedure that allows your doctors to see the internal structure of your breasts. They are highly accurate, but they are not 100 percent perfect. They can occasionally give false positives and miss a small percentage of breast cancers. On average, these x-ray tests detect between 80 to 90 percent of breast cancers in women who have no symptoms. However, the American Cancer Society does argue that mammograms are more accurate in postmenopausal women than those in the reproductive age range. This may be due to younger women's breasts being less dense (less fatty tissue). Dense tissue and cancer show up white on an x-ray, and in these cases, determining whether you have cancer or not can be difficult. You may be asked to undergo an ultrasound, MRI, or biopsy as well.

Despite its flaws, the American Cancer Society argues that mammography is the single most effective method of early detection because it can identify cancer years before you would ever develop a physical symptom.

In November of 2009, the U.S. Preventive Services Task Force (USPSTF) stirred up controversy in the breast cancer community by recommending that women between 40 and 49 not receive regular mammograms; women between 50 and 74 should receive regular mammograms every two years; and women should no longer perform breast self exams.

You may be concerned about these new recommendations. What do other healthcare organizations have to say about this? Pushing the age of regular mammograms by 10 years seems like a drastic change!

Many of the leading healthcare groups are sticking firm to their old guidelines. One of these groups, the American College of Obstetrics and Gynecology argues that women between age 40 and 49 should have a screening mammogram every 1-2 years, women over 50 should be screened every year, and all women should continue to perform breast self-exams.

In addition to the American Cancer Society and the American College of Obstetrics and Gynecology, major medical centers around the U.S. are sticking to current guidelines that screenings begin at age 40. According to ABC News, these include Duke Medical Center, Johns Hopkins, Mayo Clinic, Vanderbilt Ingram Cancer Center, and UCLA Iris Cantor Center for Breast Imaging.

For the complete listing, go to ABC News by clicking HERE.

Otis W. Brawley, M.D., the chief medical officer of the American Cancer Society released this statement:

"The most recent data show us that approximately 17 percent of breast cancer deaths occurred in women who were diagnosed in their 40s, and 22 percent occurred in women diagnosed in their 50s. Breast cancer is a serious health problem facing adult women, and mammography is part of our solution beginning at age 40 for average risk women."

With all this information, it is important for you to come up with your own opinions. At Women's Healthcare Topics, we continue to believe that regular mammogram screenings should start at age 40 and women of all ages should do regular self-breast exams.

"From my 26 years of obstetric clinical experience, I think that stopping self-exams and postponing breast screening by 10 years is absolutely ludicrous. I have seen quite a number of breast cancers before menopause as after," says Dr. James W. Brann, MD, president of the Baby Crib, LLC, which owns Women's Health Care Topics.

"Having regular mammograms in your 40s can save your life. By postponing these by 10 years, your cancer might have metastasized and it is very hard to treat. If you care about your health, you should continue your regular breast cancer screens."

To learn more about breast cancer screening, click here:

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