Breast cancer is the most common cancer in women and the second leading cause of cancer-related death in the United States. Each year, nearly 40,000 women will die of breast cancer. This is why prevention and early detection are key.
Dr. Monet Bowling, Indiana University Health breast surgical oncologist, shares insight into misconceptions surrounding breast cancer, as well as treatment and prevention options.
Who is at risk for breast cancer?
We are all at risk for breast cancer, but people with a personal or family history of breast, ovarian or pancreatic cancers or melanoma are at an increased risk.
Additionally, people who are overweight, women who begin menstruating at an early age or begin menopause late are also at an increased risk because they are exposed to the estrogen hormone for longer periods of time. This is why people who have been on prolonged hormone replacement therapy for longer than five years are also at a higher risk for breast cancer.
What are some misconceptions about breast cancer?
Do not ignore your family history from either side of the family – if you have a genetic link to breast cancer, it can be spread through your father’s or mother’s side. Some people incorrectly assume that having a needle biopsy or having surgery can cause breast cancer to spread. This is not true.
Also, many men do not think they are at risk for breast cancer when in fact, they account for 1 percent of all cases. Men typically present with larger lumps or more inflammatory cases due to ignoring warning signs.
How is breast cancer detected and treated?
Breast cancer can be detected through mammograms, tomosythesis 3-D imaging, MRIs and ultrasounds. Women should get a mammogram every year starting at the age of 40 and should also have an annual exam performed by a health professional.
When cancer is detected, there are multiple surgical options including a lumpectomy (a partial mastectomy and removal of margin of normal surrounding tissue), a mastectomy – which is complete removal of the breast – and a sentinel lymph node biopsy. Mastectomies are commonly followed up with breast reconstructive surgery. Chemotherapy, radiation and hormonal therapy are also options, depending on the patient.
Should all carriers of the BRCA gene mutations have their breasts removed like Angelina Jolie chose to do?
About 10 percent of the breast cancer population carries the BRCA-1 or BRCA-2 genetic mutation. These people have a lifetime risk for developing breast cancer between 40-85 percent. Relatives of carriers need to undergo genetic testing and should have a very long conversation with their genetic counselor, OBGYN and breast surgeon about how they want to proceed.
Simply being a genetic carrier does not necessarily mean you need to have bilateral (both breasts) mastectomies. These patients also have surgical and chemical intervention options. All of this should be discussed with your medical team.
What are options for preventing breast cancer?
Exercising and losing excess weight can reduce your risk for breast cancer. This is because fat cells in your body carry estrogen, so you can actually reduce your risk for breast cancer by 18-20 percent by losing weight and staying active.
Additionally, breastfeeding and giving birth are protective measures because they stop the hormone cycles, exposing women to less estrogen for a period of time. People at high risk for breast cancer have medication options to head off the disease, but that should occur only under the advisement of a breast specialist.
For more information on prevention or genetic counseling and testing, visit the Catherine Peachey Breast Cancer Prevention Program of the IU Health Simon Cancer Center.
More information
There are three general levels of breast cancer treatment at the IU Health Simon Cancer Center:
– High risk. At this stage, you don’t have breast cancer but for various reasons are at high risk to develop it. You will be watched closely, with clinical breast exams, annual mammograms and possibly breast MRI to detect breast cancer at its earliest development. Genetic testing to check for mutations that cause breast cancer may be needed. Lifestyle changes and medications to prevent breast cancer are offered through our prevention program.
– Early stage. At this stage, the cancer is small and treatment is highly successful. There is no hurry, so you and your doctor have time to consider all treatment options.
– Late stage. With late stage cancer or recurring cancer, treatment begins with an honest conversation about realistic options. Even at this stage, intense, multidisciplinary approach to treatment yields many good outcomes and an improved quality of life.
– Clinical trials that offer new therapies for treatment of advanced breast cancer may be an option.
