Going Beyond "Thinking Pink" to Thinking Prevention and Detection - October 2015

October 1, 2015

October is National Breast Cancer Awareness Month. “Think Pink” slogans and  pink ribbons are highly visible, and J. W. Bolen, Jr., MD, Radiologist at Twin County Regional Hospital, discusses the importance of leveraging that awareness to move people to action to protect themselves and their loved ones against the disease.

“Education is critical in battling breast cancer, and what’s equally crucial is taking the proper actions to reduce your risk of developing the disease,” says Dr. Bolen at Twin County Regional Hospital. “Creating a personal early detection plan to identify your risk factors and monitor your health and scheduling annual mammograms are two things that could save your life. Twin County Regional Hospital offers digital mammography technology which is even more effective in early detection.”

Dr. Bolen recommends consulting with a physician to discuss individual risk factors and identify key lifestyle changes that could reduce one’s chance of getting breast cancer. In addition, people can utilize several online resources, such as the National Breast Cancer Foundation’s online risk assessment tool, to create personalized early detection plans.

The Importance of Early Detection

According to the National Cancer Institute, when breast cancer is detected early, the five-year survival rate is 98 percent. However, more than 30 percent of women are diagnosed beyond the early detection window. This has lead to higher mortality rates.

Currently for women, breast cancer is second only to lung cancer in terms of mortality. Last year, more than 230,000 new cases of breast cancer were detected among women and more than 2,100 cases among men. Nearly 40,000 of these women (almost 20 percent) and 500 of these men (nearly 25 percent) died.

“The research regarding early detection is very encouraging. We just need to be proactive in prevention and detection,” says Dr. Bolen. “Along with consulting their physicians, people can start by living healthy lifestyles - eating right, staying active and maintaining a healthy weight. Women also should perform breast exams at home every month and make annual exams with their gynecologists a priority. Most importantly, if you notice a change in your breast, talk to your doctor immediately."

Tips for Prevention and Detection

Understanding the risk factors is the first step to prevention. While anyone can develop breast cancer, people displaying certain behaviors, demographics and health profiles are more prone to the disease. These include:

  • Women with a history of breast cancer have a 3- to 4-times increased risk of developing a new breast cancer, unrelated to the first one, in the other breast or in another part of the same breast. 
  • Women with a family history of breast cancer. Having a mother, sister or daughter who has (or has had) breast cancer increases your risk for developing the disease. The risk is even greater if your relative had cancer in both breasts or developed the breast cancer before menopause. 
  • Women over age 50. About 77 percent of women diagnosed with breast cancer each year are over age 50, and almost half are age 65 and older. 
  • Women with a previous breast biopsy result of atypical hyperplasia, or those with a previous abnormal breast biopsy indicating fibroadenomas with complex features, hyperplasia without atypia, sclerosing adenosis and solitary papilloma. 
  • Carriers of alterations in either of two familial breast cancer genes called BRCA1 or BRCA2.
  • Caucasian women are at a slightly higher risk of developing breast cancer than are African-American, Asian, Hispanic and Native American women. 
  • Women who have their first child after age 35 or never have children.
  • Women who started menstruating before age 12.
  • Women who begin menopause after age 55.
  • Overweight women, with excess caloric and fat intake (especially post-menopause). 
  • Women who have 2 to 5 alcoholic beverages a day are 1.5 times more likely to develop breast cancer than women who drink no alcohol. 
  • Those exposed to excessive amounts of radiation, especially before age 30. 
  • Women who use Hormone Replacement Therapy (HRT) for an extended period of time. (Risk seems to return to that of the general population after discontinuing use for five years or more.) 
  • Those with other cancer in the family. A family history of cancer of the ovaries, cervix, uterus or colon increases your risk of developing breast cancer. 
For people who display one or more of those risk factors, it is important to understand and be able to detect the symptoms. While breast cancer often has no symptoms in its early stages, the following symptoms may be present as a tumor develops:
  • A lump in the breast or underarm that persists after your menstrual cycle 
  • A marble-like area under the skin 
  • Swelling in the armpit 
  • Persistent breast pain or tenderness 
  • Any change in the size, contour, texture or temperature of the breast 
  • A noticeable flattening or indentation on the breast 
  • A change in the nipple, such as an indrawn or dimpled look, itching or burning sensation, or ulceration 
  • Unusual discharge from the nipple 

For more information about early detection or to schedule your mammogram, please call Twin County Regional Hospital Diagnostic Imaging Center at (276) 236-1680.

How to Perform a Breast Exam at Home

Courtesy: American Cancer Society

Lie down on your back and place your right arm behind your head. The exam is done while lying down because, when lying down, the breast tissue spreads evenly over the chest wall and is as thin as possible, making it much easier to feel all the breast tissue.

Use the finger pads of the 3 middle fingers on your left hand to feel for lumps in the right breast. Use overlapping dime-sized circular motions of the finger pads to feel the breast tissue.

Use 3 different levels of pressure to feel all the breast tissue. Light pressure is needed to feel the tissue closest to the skin; medium pressure to feel a little deeper; and firm pressure to feel the tissue closest to the chest and ribs. It is normal to feel a firm ridge in the lower curve of each breast, but, you should tell your doctor if you feel anything else out of the ordinary. Use each pressure level to feel the breast tissue before moving on to the next spot.

Move around the breast in an up and down pattern starting at an imaginary line drawn straight down your side from the underarm and moving across the breast to the middle of the chest bone (sternum or breastbone). Be sure to check the entire breast area going down until you feel only ribs and up to the neck or collar bone (clavicle).

Repeat the exam on your left breast, putting your left arm behind your head and using the finger pads of your right hand to do the exam. While standing in front of a mirror with your hands pressing firmly down on your hips, look at your breasts for any changes of size, shape, contour or dimpling, or redness or scaliness of the nipple or breast skin.

Examine each underarm while sitting up or standing and with your arm only slightly raised so you can easily feel in this area.