C. Nic Moga, M.D.
Birthing Centers, Obstetrics & Gynecology (OB-GYN), Women's Health
Unfortunately, breast cancer is a common malignancy among women. It’s estimated that one in 11 women will develop it during their lifetime. Additionally, approximately 230,000 women will be diagnosed with invasive breast cancer and 40,000 women will die from the disease in 2014. Breast cancer is second only to lung cancer in number of deaths each year.
There are many risk factors for breast cancer, but by far and away the most significant is age. In general, we are far more aggressive in screening patients who are in their 60s than those, for example, in their 20s.
Another important, but thankfully uncommon, risk factor is inheritance of the BRCA gene, which Angelina Jolie has; this is why family history needs to be a central part of your visit with your doctor. Other characteristics that may increase your risk include starting menstrual cycles at a young age (younger than 12) or menopause at a late age (older than 55), having a close relative with breast cancer or a personal history of a breast biopsy.
The classic symptom of breast cancer is a newly found mass that is not painful and can’t be moved. However, there are other symptoms associated with breast cancer, including skin changes, nipple discharge, swelling under the arms and tenderness. Any changes that a woman notices should be discussed with her health care provider.
Fortunately, there are behaviors that decrease a woman’s risk for breast cancer. These include breast feeding, increased physical activity and not smoking. Other factors that may help include following a diet high in vegetables and low in red meat, and limiting your alcohol intake.
As health care providers, we are informed by different organizations about the appropriate age to begin mammograms and oftentimes find these recommendations confusing and even contradictory. I always tell my patients that if we find things a bit confusing, I’m sure they do as well. A good rule of thumb is starting at age 40. However, certain cases dictate screenings earlier or later in life.
The best advice is that every woman should meet with her health care provider to have her health history reviewed and to discuss the risks and benefits of screening. You can then make an informed decision about what is best. Every woman has a different history, so it’s difficult to make blanket statements about when everyone should get a mammogram. Some high-risk women (BRCA gene, exposure to radiation as a child) may need to start sooner than age 40, and some low risk women may elect to start at a later age, such as 50.
As crucial as our focus on breast cancer should be, it’s also imperative that we realize that the No. 1 cause of death in women is heart disease, which kills 10 times as many women each year than breast cancer. Yes, it’s important to get your mammogram and examination, but it’s prudent to get your cholesterol checked as well.
Talk to your health care provider about ways you can prevent and screen for illnesses that afflict women.