by Dr. Robert A. Gardner, General Surgeon and Breast Surgeon
One in every two women in the United States today will consult someone in the medical system for a breast condition or problem in her lifetime. Most of those will be benign, some will be malignant.
This year, 192,000 women in our country will develop invasive cancer of the breast, 62,000 will develop in situ carcinoma of the breast, and 60,000 to 70,000 will develop lobular carcinoma in situ, not really a malignancy of the breast but a marker lesion that doubles the risk of breast cancer. This year, 40,300 women are expected to die from metastatic or locally recurrent breast cancer. WE CAN DO BETTER. We must do better. Allow me to show you how.
One out of every seven women in our country will develop breast cancer in her lifetime. While the mortality from breast cancer is decreasing, the number of breast cancer cases is increasing in part due to the aging population of women in their 50’s, 60’s, 70’s and 80’s where the incidence is high and gets higher until the late 80’s.
The best insurance against death from breast cancer is early detection and diagnosis. That leads to cure most of the time.
A woman’s awareness of her own breast is of critical importance. About four out of every ten women who develop breast cancer have some change in the breast that they noted which will often bring them in for consultation, mammography, ultrasound or other. Awareness is crucial. Competent breast self-examination is still important.
The best tool for early detection, diagnosis and treatment is mammography. Most mammograms in south Florida today are done with digital technology. Analog films are still being done and are useful but we can see the evidence of pathology more clearly with digital films. A woman coming for a mammogram should know if her facility has a CAD (computer aided detection) unit available to her interpreting radiologist who will be looking at her mammogram.
Screening mammograms are for women who have no signs, symptoms, preexisting disease in the breast, prior breast surgical procedures, etc. More and more mammograms are done as diagnostic mammograms because it gives us the freedom to do the extra views we think we might need, even while the woman is still at the facility. By looking at a woman’s films early in our breast center, we are able to note dense breasts, a risk factor for breast cancer by itself, which also leads us to request a surveillance breast ultrasound be carried out. These two tools—mammography and ultrasonography—are invaluable in the detection of very early breast cancer. It is this writer’s opinion that each woman over the age of 40 should have a dedicated clinical breast examination at least once a year done by the clinician of her choice. At that breast examination, it is appropriate to make sure there are no symptoms such as nipple discharge, redness, swelling, unusual breast pain, scaling of the nipple, etc., and to spend a few minutes between the woman and her examining clinician to make sure her mammogram is up-to-date, determine if she needs ultrasound or MRI, and schedule her next dedicated breast visit based on her level of risk and related issues.
READ FULL ARTICLE; Breast Cancer and the United States -2010, by Dr. Robert A. Gardner, General Surgeon and Breast Surgeon
