Breast Cancer: A Year-Round Survival Guide

breast xray(BlackDoctor.org) — October is National Breast Cancer Awareness Month, and while breast cancer deserves our attention year-round, a national month of recognition serves to remind all Americans that breast cancer is a disease that impacts women (and men) of all ages, backgrounds, ethnicities and nationalities.

Breast cancer is the most common cancer among American women, as well as among African American women. And although breast cancer is the most common cancer, it remains the second leading cause of cancer-related death among women behind cancer of the lungs.

Very disturbing disparities exist between African American women and white women when it comes to breast cancer screening, diagnosis and survival, and these will be outlined below.

What Is Breast Cancer

Breast cancer is a malignant growth or tumor that frequently begins to manifest in the milk ducts or lobules of either breast.

Breast cancer can be divided into two groups: invasive and non-invasive cancers. Non-invasive breast cancers are also called “carcinoma in situ” and are generally confined to the duct areas without affecting surrounding tissue. Non-invasive breast cancers can be subcategorized as “ductal carcinoma in situ” (DCIS) and “lobular carcinoma in situ” (LCIS). LCIS is actually not considered a cancer, per se. Rather, it is seen as a warning sign that can potentially lead to invasive cancer when undetected.

Invasive breast cancers may develop in the lobules or ducts but then spread into surrounding breast tissue, and can often further metastasize to the lungs, brain, liver, bones, and other major organs. Approximately 80% of invasive breast cancers fall into the category of invasive ductal carcinoma.

Stages of Breast Cancer

• Stage 0. breast cancer is known as carcinoma in situ, the most common being DCIS, as described above.

• Stage 1. Breast cancer signifies early invasive cancer in which the tumor has not spread beyond the breast tissue and is no more than ¾ of an inch in diameter.

• Stage 2. Breast cancer involves a tumor between ¾ of an inch and 2 inches in diameter with some involvement of the local lymph nodes under the arm.

• Stage 3. Breast cancer can involve a combination of various factors, including larger tumor mass, involvement of lymph nodes behind the breast bone, tumor spread into the chest wall or skin of the breast, or under or above the collar bone. Stage 3 also may manifest as inflammatory breast cancer, a rare form of breast cancer wherein the breast becomes red and swollen due to the blockage of lymph vessels in the breast tissue and skin.

• Stage 4. Breast cancer involves the spreading of the disease to other parts of the body and distant organs, a process often referred to as metastasis.

Screening

Breast self-exam (BSE) is an important part of self-screening for women of all ages, although studies show that the percentage of women who practice regular monthly BSE is relatively low.

Mammograms are a very crucial aspect of breast cancer screening, and is still considered the best method of early detection. Starting at the age of 35, annual mammograms are recommended for all women, as well as an annual clinical breast exam by a qualified medical professional.

MRIs of the breast are also utilized for special magnification views, yet mammograms remain the gold standard for early detection.

Treatment

Breast cancer is generally treated with a combination of chemotherapy, hormonal therapy, radiation, and surgery.

Chemotherapy and hormonal treatments are systemic therapies that target cancer cells that have traveled to areas of the body beyond the breast. Surgery and radiation are localized treatments focusing specifically on the breast tissue itself.

Breast cancer surgeries may be “breast conserving”, wherein “lumpectomies” and other localized surgeries endeavor to conserve as much viable non-cancerous breast tissue as possible. Mastectomies can involve the removal of a portion of the breast tissue and local lymph nodes, as well as radical surgery that encompasses the entire breast and portions of the chest wall, when necessary.

Male Breast Cancer

Only 1% of all breast cancer cases occur in males, and usually between the ages of 60 and 70.

Due to the fact that men have little breast tissue in comparison to women and are often diagnosed with cancer much later in the disease process, male breast cancer frequently involves the chest wall and other surrounding tissue. Men are generally unaware that they are susceptible to breast cancer and thus will ignore the symptoms until the disease has progressed significantly.

Breast Cancer and African American Women: Disturbing Statistics

Although African American women have a lower incidence of breast cancer than their white counterparts, they actually have a higher risk of death from breast cancer, a statistic that scientists are still endeavoring to fully understand.

Some studies have indicated that breast cancers grow more rapidly in African American women and are less responsive to hormone-based therapies. Other studies have also demonstrated that African American women tend to be diagnosed at later stages of the disease than white women, and various factors have been considered to explain this racial difference in diagnosis, including the fact that African American women undergo fewer mammograms.

According to an article on the website of the Black Women’s Health Imperative (www.blackwomenshealth.org), both insured black women and uninsured white women wait twice as long to receive “a definitive breast cancer diagnosis” than white women who are insured, and black women “waited twice as long as white patients to begin treatment after breast cancer diagnosis”.

Additionally, a study by the American Journal of Public Health found that African American women are less likely to receive appropriate cancer treatment, a conclusion that calls for greater advocacy and racial parity in screening, diagnosis and treatment. This is underscored by the fact that the 5-year survival rate from breast cancer among African American women is 69%, whereas the 5-year survival rate for white women is 84%, another disturbing racial differential.

Breast Cancer: Action Is Still Needed

Breast cancer is still a very serious public health issue for American women, and racial disparities regarding screening, diagnosis and treatment of breast cancer have a significant negative impact upon African American women, and are indeed a cause for alarm, action and advocacy.

Breast self-exam, annual mammograms, and annual clinical breast exams are all important aspects of early detection that all women should undertake and advocate for on their own behalf.

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The Truth Behind Mammography Myths

mammogram

Mammogram

(BlackDoctor.org) — Breast cancer is one of the most common cancers in women. Because not all lumps necessarily mean cancer, and not all cancers can be detected by touch/physical examination, until it becomes large enough, a mammogram is the best way to detect cancer early.

Although it is not 100% accurate, the mammogram can:

• Detect lesions in their very early stage
• Detect lesions that are not palpable
• Detect lesions before they are palpable
• Give important information about the “lump” or change you or your doctor feels

Regular mammograms may therefore give you a better chance of picking up early breast cancer than the occasional mammogram.

So what myths/questions are stopping you from making your appointment?

It’s Too Painful

You will feel some pressure as the mammogram is performed, but any discomfort will only last a few seconds. Because breasts are more sensitive just before your menstrual period, you should try to schedule your mammogram seven to 10 days after the start of your period.

I Can’t Afford It

Routine mammograms in women over age 40 are considered preventive care and are covered by most insurance companies. If you have Medicare, Medicare will help pay for a mammogram once a year. There are also state and federal programs to help women pay for a mammogram every year. You can call the American Cancer Society toll-free, 800-227-2345, for more information.

I’m Not At Risk For Breast Cancer

“If you’re a woman, you’re at risk for breast cancer,” says Dr. Gregory. “Almost 70 percent of women with breast cancer have no known risk factors.”

I Don’t Feel A Lump Or Have Any Symptoms

The reality is, screening mammograms are for women with NO lumps or other symptoms. The best time to find cancer is before you can feel it.

A mammogram can detect cancer as much as a year or two before you or your physician could feel it. Breast cancer found in its earliest stages offers the greatest chance of remission and survival.

I Don’t Know Where To Go

By doing a little research and asking the right questions, you can ensure you’re receiving a high-quality mammogram. The American Cancer Society recommends that you:

• Ask to see the FDA certificate that is issued at the center. The FDA requires that all facilities meet high professional standards of safety and quality.
• Use a facility that specializes in mammograms and does many mammograms a day.
• If you are satisfied with the quality, go to the same facility on a regular basis so your mammograms can be compared from year to year.

Isn’t The Radiation Dangerous?

With modern mammography machines, the high-quality images produce a low amount of radiation. “Strict guidelines are in place to ensure that the equipment uses the lowest dose of radiation possible,” says Dr. Gregory. “The doses are very small and tightly regulated by the FDA.”

My Self-Exams and Annual Checkups Are Enough For Me

Mammography can typically spot lesions one-fifth the size of those that can be felt by hand during self-examination or clinical breast examination by a healthcare professional. For example, an experienced examiner can feel a lump the size of a small pea. Mammography can find a lump the size of a grain of rice. Overall, mammography can pick up about 40% of cancers that are too small to detect by touch on clinical examination.

My Doctor Did Not Recommend a Mammogram

In most studies, they have found that the reason women most frequently give for not having a mammogram would be whether their primary health care doctor suggested it. If your doctor does not suggest mammography and you are in the correct age group and if you have some risk factors, it will be up to you to raise the issue.

I Am Too Young For a Mammogram

Although in screening programmes, the age of 40 or 50 is always mentioned, any person who has signs or symptoms suggestive of breast cancer needs appropriate evaluation, regardless of age. Even males with suspected breast cancer undergo mammograms. In addition, if breast cancer runs in your family and tends to occur early, you may need a different recommendation for mammography. Always consult your doctor or a radiologist.

Why Have a Mammogram When It Is Not 100% Accurate?

No test in medicine is 100% accurate. However, all results are interpreted with their limitations and limits of accuracy in mind. For example, the ECG (electrocardiogram) done for a patient with chest pain may be normal (rarely so) even if the patient is suffering from a heart attack. An exercise stress test for the heart may only pick up about 70% of those with narrowing (stenosis) of the heart blood vessels of more than half its diameter.

Remember that most African American women should have their first baseline mammogram at age 35. Talk to your doctor to get the help and information that you need that’s right for you.

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