Recent news reports on the results of an international breast cancer study
of Russian and Chinese women have left some American women confused about
the importance of regular breast care.
The study, published in the Cochrane Library in July, found that monthly
breast self-exams do not lead to increased breast cancer survival rates -
and in fact may lead to unnecessary breast biopsies. The study included more
than 388,500 women in Russia and China who ranged in age from 30 to 66.
The study's findings have prompted even the American Cancer Society to label
monthly self-exams as "an option."
But what does this new information really mean for women here in the United
States and around the world?
Overall, the key message is to get medical attention for any breast lumps,
changes or abnormalities that you may find - regardless of whether those
lumps are found during a self-exam, in the shower, while getting dressed,
looking in the mirror, or if your spouse or significant other notices
changes in your breasts.
According to the American Cancer Society, if you decide to do a monthly
self-exam (which we feel is still beneficial), you should have your doctor
or nurse check your method to make sure you are doing it right. By doing a
regular exam, you get to know how your breasts normally look and feel. Then
you can more easily notice changes. (Of course, many cancer experts now
agree that it's OK not to do a self-exam on a fixed schedule.)
Remember to see your doctor right away if you notice a lump or swelling;
skin irritation or dimpling; nipple pain or the nipple turning inward;
redness or scaling of the nipple or breast skin; or a discharge other than
breast milk. And remember that most of the time these breast changes are not
cancer.
Regular breast care for women age 40 and older also consists of a yearly
clinical breast exam by a health expert and an annual screening mammogram.
In a screening mammogram, each breast is X-rayed in two different positions:
from top to bottom and from side to side. When a mammogram image is viewed,
breast tissue appears white and opaque and fatty tissue appears darker and
translucent.
Women in their 20s and 30s should have a clinical breast exam as part of a
regular health checkup every three years.
Understanding mammogram results
Although it causes fear in most women, abnormal results from a mammogram are
more common than you may think. An abnormal report doesn't mean you have
breast cancer. It means that you should meet with a physician to decide if
you need extra tests.
Potential abnormalities are found in less than 10 percent of women who have
screening mammograms. This small group of women needs further evaluation
that may include diagnostic mammography, breast ultrasound, or needle
biopsy.
A potential abnormality on a mammogram may be called a nodule, mass, lump,
density or distortion.
What if something suspicious is found on my mammogram?
If there is a suspicious finding on your mammogram, you will typically need
to have additional views and/or ultrasound performed.
A radiologist will consult with you and will recommend additional evaluation
to make a diagnosis. This might be ultrasound-guided core biopsy,
stereotactic breast biopsy, cyst aspiration, needle localization and
surgical consultation, or MRI-guided biopsy.
Ingalls Memorial Hospital makes every attempt to schedule and perform these
procedures as soon as possible so that our patients do not have to endure a
long wait to find out whether or not they have breast cancer.
When is an ultrasound recommended?
Ultrasound is used to evaluate any palpable breast lesion and to evaluate
masses, distortions, or asymmetries found on mammography or MRI.
Ultrasound forms images of the breast utilizing sound waves, not X-rays. No
compression is required; a warm gel is placed on the skin, and an ultrasound
probe is rubbed over the skin to obtain the image.
Ultrasound often can show abnormalities that might go undetected on
mammography due to extremely dense breast tissue. Ultrasound is used most
commonly in conjunction with mammography, not as a replacement for
mammography.
Are there new techniques to improve accuracy?
There are many exciting technologies being investigated in the field of
breast imaging. All of this work is in the hopes of detecting breast cancer
at the earliest stage possible to allow patients the best chance for a cure.
Source : Alexander Starr, M.D., is a board-certified
oncologist/hematologist and medical director of Ingalls Memorial Hospital's
Richard K. Desser Breast Center. Lisa Gravitt, R.N., B.S.N., O.C.N. is a
breast cancer nurse navigator at Ingalls, which is a member of the Southland
Health Alliance. For more information on the alliance, visit
www.southlandhealth.org or call (800) 221.2199.