Breast Cancer Screenings at Fenway
What Is Breast Cancer?
Breast cancer is a malignant (cancerous) tumor that starts from
cells in breast tissue.
How Common Is Breast Cancer?
Second to skin cancer, breast cancer is the most common cancer in American women, and second to lung cancer, breast cancer is the
cancer most likely to cause death. Fortunately, with improvements in screening
and treatment, many women are living longer lives after a diagnosis of breast
cancer.
How Do I Know If I Am At Risk
For Developing Breast Cancer?
Breast cancer is 100 times more common in women than men. All
women are at risk: across a lifetime, 1 in 8 women will develop the disease.
There is not yet enough research to accurately determine the risk
of breast cancer in transgender people. Until more is known, we suggest
screening based on physical structure and what is known about the risks of
taking estrogen (people with breasts and people taking estrogen for at least 5
years should follow the screening recommendations for women outlined below).
Do Some Women Have A Higher
Risk Than Others?
Some women do have a higher risk than other women. Other than
gender, risk factors for developing breast cancer include:
- Increasing age (the older you are, the higher the risk).
- A family history of breast cancer.
- A known genetic susceptibility to breast cancer.
- A history of radiation treatment to the chest wall.
- A history of breast biopsies.
- Never having given birth.
- Having children
after age 30.
- Beginning menstruation before age 12.
- Undergoing
menopause after age 55.
- Heavy alcohol
consumption.
- Obesity.
Is There Anything I Can Do To Reduce My Risk?
Although many breast cancer risk factors (e.g. age, family
history) cannot be changed, we recommend that you follow a healthy diet and
exercise program and avoid heavy alcohol consumption.
The National Cancer Institute has developed a Breast Cancer Risk
Assessment Tool (see: http://www.cancer.gov/bcrisktool/)
to help identify women who have a very high risk for developing breast cancer,
since these women may benefit from taking medicines to prevent breast cancer. However, this tool does not apply to every
woman, so it is important to talk with your health provider about your
individual risk.
For some women who have a very high risk because of family or
genetic history, additional prevention strategies, such as surgery to remove
the breasts, may also be considered.
What Is Breast Cancer
Screening? What Should I Be Doing About It?
The purpose of screening is to find
breast cancer early, when the growth of abnormal cells is small and the cancer easier
to treat.
A number of healthcare agencies have
issued breast cancer screening guidelines, but their recommendations are not
always consistent. This is because none of our currently available tests are
perfect.
Breast Self-Exam (BSE) involves checking your own breast tissue for lumps, changes in
size or shape, or anything out of the ordinary in the breast tissue or underarm
area. Studies do not show better outcomes when women do BSE regularly. In
addition, doing BSE can make some women feel more anxious about breast cancer,
since it is common to find lumpy areas that are not cancerous, but then need a
workup to prove they are not cancerous (so-called “false-positives”). That
said, many women do find their own breast cancers themselves. Whether or not to
do BSE is therefore a personal decision that each woman must make for herself.
BSE is not intended to take the place of other breast cancer screenings. If at any
time you notice a change in your breasts, please tell your health provider
immediately. Abnormalities large enough
to be found by BSE in younger women often turn out to be benign lumps such as
cysts and can be easily diagnosed by ultrasound.
Clinical Breast Exam (CBE) is an examination by a trained health provider who uses their
hands to feel for lumps or other changes.
Mammograms are x-rays of breast tissue that show changes that may be too
small for a person or their health care provider to feel in a breast exam. They
are rarely recommended for women under 40.
Recommendations for how frequently mammograms should be done over 40
have changed and should be discussed between the woman and her physician.
Magnetic Resonance Imaging
(MRI) screening uses magnets and radio waves (not x-rays) to
create a cross-sectional, detailed image of the breasts. They are usually
reserved for special high risk situations such as women with genetic mutations
or family histories which increase the likelihood of breast cancer
significantly.
Currently, there is no “one
size fits all” breast cancer screening strategy. Please talk to your health
care provider to determine the best screening program (which test, what age to
start, how often to do the test(s), what age to stop) for your individual
circumstance.
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