Breast Health

Breast cancer is one of the most common forms of cancer in American women.  It is the second leading cause of death. 1 out of 8 American women will develop breast cancer in their lifetime.

Risk Factors for breast cancer can include:

• Age - 76% of cases are over 50 (CDC)
• Family history of breast cancer
• Women who have never had children
• Women who had first child after 30
• History of breast cancer of opposite breast
• Hormone Replacement Therapy (Synthetic) for more than 5 years
• First menstrual cycle was early and/or late menopause. Typical age for first menstrual cycle is 13.
• History of colon or uterine cancer
• Heavy alcohol consumption

It is important to detect breast cancer early to improve chances for survival and also allows for more options for treatment.

Self-examinations
Perform monthly breast self-examinations to check for changes in your breasts. It is normal for your breast to feel a little lumpy and uneven.  It is also normal for your breast to feel tender or swollen before or during your menstrual cycle. Do your self exam at the same time of the month each month. In my office, during your initial or annual self-examination, we teach you what is normal or abnormal to give you a better idea of what you should be feeling.

Women in your 40s please note, self-exams are in addition to annual mammograms.  According to the NWHIC 70% of breast cancers are self-detected.

Clinical Exams
Your clinical exam consists of an evaluation of your family history and a thorough physical exam.  The doctor examines your breast and feels for lumps or inconsistencies in your breast.

Mammogram
A mammogram should be performed every 1 to 2 years for women, starting in their 40s depending on their individual history.  A woman who has a mother or sister who has breast cancer should receive annual mammograms.  For example if your mother dev pre-menopausal breast cancer at age 45 your annual mammogram we suggest you begin at 35 - 10 years prior to her diagnosis. In general women should have a baseline mammogram after 35. Typically the recommendation with no family history every 2 years between 40-50 and every year after 50.

A mammogram is the best way to find breast cancer before symptoms occur. If a mammogram looks suspicious, further testing may be needed. This may include additional mammograms, ultrasound or a biopsy to determine if the suspicious mass is cystic or solid.  Mammogram testing is not infallible. The test can sometimes give false negative or false positive results.

Screening Recommendations for Women

Childbearing Years- Age 18-39

• Clinical Breast exam every 1-3 years
• Pelvic exam and Pap smear every 1-3 years once sexually active
• Dental exam every 6-12 months
• Fasting cholesterol testing every 5 years
• Baseline mammogram once between age 35-39

Middle Years- Age 40-64

• Yearly clinical breast exam
• Yearly pelvic exam and Pap smear
• Mammogram at least every other year during the 40's and yearly in the 50's
• Dental exam every 6-12 months
• Colonoscopy at age 50, or as directed by your provider
• Fasting cholesterol and glucose testing yearly

Other tests that may be recommended for women with risk factors

• Women with a first-degree relative with breast cancer: Baseline mammogram 10 years prior to the diagnosis of the relative's cancer if diagnosed prior to menopause
• Women with first-degree relative with colon cancer: Colonoscopy 10 years prior to the diagnosis of the relative's cancer
• Skin examination by a dermatologist if there is a history of excessive sun exposure or pre-cancerous changes

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