Breast Health Question and Answer

We know that early detection means that the statistics for breast cancer are up. How many women can expect to be diagnosed in the next 12 months?

It's estimated that 212,920 women will be diagnosed with breast cancer in the next year. In that same timeframe, an estimated 40,970 women will die of the disease.

How is breast cancer diagnosed?

Diagnoses are made earlier due to advanced screening mammography and our ability to detect cancer at earlier stages.

• Breast ultrasound
• Diagnostic mammogram
• Magnetic resonance imaging (MRI)
• Biopsy

If breast cancer is diagnosed, other tests are done to find out if cancer cells have spread within the breast or to other parts of the body, in a process called staging. The type and stage of breast cancer lets the doctor know what kind of treatment you need.

When should I get a mammogram?

Mammogram screening recommendations vary from different government-sponsored groups and medical societies. We understand that this can become confusing when making personal decisions. At Women & Infants, we recommend the following screening strategy for average risk women:

• Women under 40 – Mammogram not generally recommended.
• Women age 40 to 49 – While our bias is to recommend annual mammogram screening in this age group, we suggest women discuss their individual health with their primary care provider.
• Women age 50 and older - Annual or biannual mammogram should continue as long as the patient has an estimated life expectancy of 10 years or more.

Recommendations for screening with clinical breast exams also vary between different government-sponsored and medical societies. We believe there is a lack of data to define the benefits of such exams and, therefore, endorse the American College of Obstetricians and Gynecologists recommendation for clinical breast examination every one to three years for women aged 20 to 39, and annually thereafter.

For more information on breast cancer or an appointment at the Breast Health Center at Women & Infants, please call (401) 453-7540. 

What is the most common type of diagnosis/breast cancer?

Invasive ductal carcinoma and invasive lobular carcinoma are the most commonly diagnosed these days.

What is the connection between breast cancer and genetics? If my sister or mother has breast cancer, will I get it?

There is a familial risk, meaning that there is an increase in risk if one has family members, especially a first-degree relative such as a sister or mother, with breast cancer. This is likely due to multiple low penetrant genes that increase risk as well as environmental factors. A small proportion of breast cancers (five to 10 percent) are due to hereditary risk in which a genetic mutation leaves the person at a much higher risk of developing breast cancer.

What are dense breasts and how does that factor into diagnosing and treating breast cancer?

Breast density describes the ability of the x-ray to penetrate the breast and give resolution on mammogram. Dense breast tissue can limit the sensitivity of mammography. Young women often have dense breast tissue. As one ages, the breast tissue often is replaced more by fatty tissue and the breast becomes less dense. Then, the mammogram is more sensitive to finding breast lesions. Digital mammography is likely better and has higher sensitivity in dense breasts. MRI for high-risk woman is also an option.

Do all breast cancer patients have chemotherapy?

No, the use of chemotherapy is determined case by case.

Is a lump in the breast always cancer?

No, a lump in the breast is not always cancer but should always be reviewed and examined by one's physician.

What is the significance of having the mutant BRCA1 or BRCA2 gene?

These are two genes that make up the majority of Breast Ovary Syndrome. If one inherits from one's mother or father a mutant brca1 or 2 gene, she will have a higher lifetime risk of cancer, including early onset breast cancer, ovarian cancer and possibly other cancers. Mutations in these genes are responsible for 5 to 10 percent of breast cancer.

Are there lifestyle choices - exercise, healthy diet, etc. - that can reduce the risk of breast cancer?

While data need to continue to evolve and this is not crystal clear for breast cancer risk, it is likely that following a healthy lifestyle including limiting fat in the diet and exercise may decrease the risk of cancer.