Breast cancer is the most commonly diagnosed cancer among U.S. women (except for skin cancers), with the American Cancer Society estimating that 281,550 new cases will be diagnosed this year. Because breast cancer screenings are a regular part of women’s wellness visits, it is common to hear about the importance of breast self-awareness, mammograms and the role genetics play, yet many women feel unprepared to talk with their doctor on these topics.
October is Breast Cancer Awareness Month, a great time to kickstart conversations about breast health. Dr. Janie Lee, Director of Breast Imaging at Seattle Cancer Care Alliance (SCCA) and Professor of Radiology at the University of Washington, shares answers to common questions about breast cancer and preventative screening.
What is my risk?
Women in the U.S. have a one in eight chance of developing breast cancer in their lifetime. Risk increases with age — most women are diagnosed after age 50, according to the Centers for Disease Control and Prevention (CDC).
The American Cancer Society notes that while the disease impacts women of all races, white women have the highest prevalence, and Black women are more likely to develop aggressive, advanced-stage cancer and are more likely to die from the disease.
The American Cancer Society also states that about 5% to 10% of breast cancer cases are hereditary, commonly due to a mutation in the BRCA1 or BRCA2 gene. Women with mutations on these or the lesser-known PALB2 gene are more likely to be diagnosed younger. The BRCA1 mutation increases the chance of diagnosis by age 80 to 70%. If you have a family history of breast cancer, genetic testing to assess your risk may be an option.
Dense breasts also bring higher risk and can mask tumors on a mammogram. Women with dense breasts should talk with their doctor about their breast cancer risk. While not all women with dense breasts are at high risk for developing breast cancer, some women with increased risk might add breast MRI to mammography for preventative screenings.
When and how frequently should I be screened?
Regular screenings increase the potential to detect breast cancer early, before symptoms begin and the disease has progressed. Early detection is also more likely to improve survival outlook.
Most women should begin annual mammograms at 40, but those at high risk or with a family history should speak to their doctor about starting screenings sooner. According to American Cancer Society guidelines, average-risk women aged 55 and older who had a normal mammogram within the last year can elect to be screened every other year.
To make mammograms more accessible, the SCCA MammoVan brings onsite screenings to communities around Seattle — check with your providers to see if a mobile mammogram service is offered in your area.
What are my screening options?
The most common screening technique is a mammogram, a low-dose X-ray of the breast. 3D mammography, also called digital breast tomosynthesis (DBT), is now the more common type of mammogram and the preferred method at SCCA — an American College of Radiology Breast Imaging Center of Excellence. This method takes many pictures at once and offers better odds of early detection.
For women at high-risk, doctors may recommend an MRI and a mammogram. SCCA offers both with leading-edge technology and is also engaged in research to improve early detection with imaging.
A supplemental way for women to monitor their breast health is to be familiar with how their breasts normally look and feel, and report changes to a healthcare provider.
What changes should I be on the lookout for?
Mammograms find more than 85% of breast cancer in women who are without symptoms. Some women may develop a lump or other symptoms. If you notice any of these, it’s important to be evaluated:
- New lump in the breast or armpit
- Thickening or swelling of part of the breast
- Irritation, dimpling, redness or flaky skin
- Pain in the nipple or any area of the breast
- Nipple discharge other than breast milk
- Change in the size or shape of the breast
While these details may help provide clarity on breast cancer risks and screening options, further information and guidance are available on the Seattle Cancer Care Alliance website.
This year, pledge to prioritize your health by speaking to your healthcare provider, scheduling your mammogram and incorporating self-checks into your routine. There’s no better form of self-care.