Along with the leaves changing colors and pumpkin spice everything, October brings the color pink for breast cancer awareness month.  We all know someone who has been affected by breast cancer, or we have been affected by it ourselves.  It is, after all, the most common malignancy in women, affecting 1 in 8, with a lifetime risk of 12%.  It accounts for 27% of all new cancers diagnosed in women (men are not off the hook; about 1 in 1,000 will develop breast cancer too).  In light of these statistics, there is some good news.  Unlike ovarian cancer, which was highlighted in last month's newsletter, early detection of breast cancer is common, affording a 5 year survival rate of 98% when detected in its earliest stages.  In fact, the mortality from breast cancer has been on the decline since 1990.

Elements Of Screening

The importance of early detection cannot be stressed enough, and this is done through the three elements of screening:

• mammography
• clinical breast exam (done in the office)
• breast self exam / self awareness

When I ask my patients if they perform monthly self exams, I am often confronted with the reply "no, I don't know what I am feeling for".  I respond that the objective is to become familiar with your own breasts so that if anything were to change, you would notice.  Some women have denser and lumpier breasts than others, so self awareness is important.  Typical symptoms that warrant further evaluation in the office include a lump anywhere in the breast including the underarm area, change in the skin texture overlying the breast (resembling an orange peel), an inverted nipple, new onset asymmetry of the breasts and nipple discharge, especially if bloody or clear.  About 40% of cancers are actually detected by patients themselves while performing self exams.  For the actual technique, check out: http://www.nationalbreastcancer.org/breast-self-exam

The other two elements of screening are just as important.  All women aged 40 and older should undergo annual mammograms, which is a special X-ray that can show small lumps even before they are palpable.  Similarly, all women aged 40 and older should have annual clinical breast exams by a healthcare provider, and those aged 20-39 should have a clinical breast exam every 1-3 years.

Genetic Factor

Another topic important to touch on is the genetic factor.  Since breast cancer is common for malignancies, patients with a family member diagnosed at some point causes patients to worry about their own risk. 

Only about 15% of women with breast cancer also have a relative with breast cancer. The highest risk is a first degree relative who has been diagnosed (mother, daughter, sister).  Therefore, 85% of breast cancers occur in patients with no family history. 

A special population, those with a BRCA mutation, account for about 5-10% of cases, but only certain patients qualify to be tested for this mutation.  If you have any questions about whether you qualify, please ask one of our doctors. Please remember, early detection is key!  While we will have to wait until May 2015 for the next Susan G. Komen Race for the Cure in West Orange, check out http://komennorthjersey.org/north-jersey-events/

for some upcoming events in the area.  Happy October, and happy screening!