By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

October 21, 2009

OCTOBER IS BREAST CANCER AWARENESS MONTH

Question:  My doctor’s office just called to tell me I have a troublesome spot on my mammogram, and I need to have further tests done. Does this mean I have breast cancer?

Answer:  Your question is very timely since October is National Breast Cancer Awareness month. Many women have abnormal mammograms that require follow-up testing. While this is cause for some concern, most of the time the follow-up tests reveal the problem to be non-cancerous. 
While there is no fool-proof way to prevent breast cancer, early detection through mammography helps ensure early treatment, which leads to a higher chance of successful treatment. Breast cancer can occur in both women and men, but the condition is relatively rare in men.  Meanwhile, apart from skin cancer, breast cancer is the most common type of cancer in women. About 210,000 women are diagnosed with breast cancer every year, and about 40,000 die from the disease. Breast cancer is the fifth leading cause of death among women. 

While breast cancer does have a hereditary tendency, there are other risk factors in play. Most notably, breast cancer risk increases with age; more than 75 percent of breast cancer cases occur in women over the age of 50.  Other major risk factors include both alcohol consumption and the prolonged use of hormone replacement therapy.  Incidence rates of breast cancer also increase among women who are overweight and not physically active, among women who have not had children, and among mothers who did not breastfeed. Finally, late onset of menstrual periods and late menopause also seem to be associated with a higher risk for breast cancer.

Mammograms aid early detection of breast cancer, but self-breast exam can also detect lumps and changes in the breast that might serve as early warning signs. Aside from lumps in or dimpling of the breast, other symptoms of cancer include changes in the shape or size of one breast; pain in the breast or nipple that does not go away; flaky, red, swollen skin on the breast; very tender nipples; and bloody discharge from the breast. If you experience any of these symptoms, seek medical assistance immediately.

The American Cancer Society currently recommends mammograms for women over the age of 40. Most gynecologists and family physicians recommend biannual mammograms for women over the age of 40 and annual mammograms for women over the age of 50. In some areas breast cancer screenings are available for uninsured and/or low-income women at little to no cost. You can otherwise schedule a mammogram through your physician’s office.
    
Treatments for breast cancer have dramatically improved since the mid-1970s, in terms of surgical options, chemotherapy agents and hormonal treatments.  Simultaneously, more women have begun seeking regular breast cancer screenings. These factors have led to a dramatic decrease in breast cancer deaths, even though more breast cancer cases are being diagnosed and reported. 

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, Communication Office, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only.  It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.