October is National Breast Cancer Awareness month. It is a time to honor breast cancer survivors and to remember those we have lost to breast cancer over the years.  By now, most everyone is aware of breast cancer and the need for early detection, but October is a great time to educate yourself on the signs and symptoms of breast cancer, who is at risk, and how to detect breast cancer early.

Stats and information

Breast cancer is the most commonly diagnosed cancer in the United States, that's men and women combined!  That number is astounding when you consider over 99% of those diagnosed with breast cancer are women.  The National Cancer Institute estimates there will be 231,840 newly diagnosed breast cancer patients in the United States in 2015.  That represents 14% of all new cancer cases in the United States.  61.1% of breast cancer diagnoses are for localized or stage 1 breast cancer for which there is a 98.6% 5 year survival rate.  32% of breast cancer diagnoses are for regional breast cancer where it has spread to Regional Lymph Nodes.  This type of breast cancer has an 84.9% 5 year survival rate.

89% of breast cancer diagnoses are in women aged 45 and up.  Community Care Physicians follows the recommendations of the American Cancer Society, which recommends annual mammograms starting at age forty for early detection.  The American Cancer society also recommends getting a clinical breast exam as part of a periodic health exam for women in their 20's and 30's, preferably once every three years.  Starting at age 40, women should have a clinical breast exam every year. 

What to look for

In a clinical breast exam, there is no x-ray of the breast, or mammogram, taken.  The health professional will examine the breast for abnormalities in size or shape, or changes in the skin of the breasts or nipples, and feel for lumps.  During a clinical breast exam, the health professional is looking for lumps they can feel or see on the breast or on the lymph nodes in the armpit.  Some of the other symptoms they might be looking for include thickening that is different from the other breast tissue, one breast becoming larger or lower, changing of nipple position or shape, nipple becoming inverted, skin puckering or dimpling, a rash on or around the nipple, or swelling around the collarbone or beneath the armpit.  Other symptoms could include constant pain in part of the breast or armpit or discharge from the nipple in the form of clear or milky liquid, yellow fluid or blood.

Paget's disease of the breast is also a symptom of breast cancer.  This syndrome presents itself with similar symptoms as eczema such as redness, discoloration, or mild flaking of the nipple skin.  Because it looks so much like eczema, it is very difficult to diagnose plus only 50% of cases also present with a lump.  In advanced stages symptoms may worsen to include itching and burning or clear or bloody discharge from the nipple.  Another form of breast cancer that is incredibly hard to diagnose is inflammatory breast cancer because it presents with no lump.  Symptoms of inflammatory breast cancer resemble symptoms of breast inflammation such as pain, swelling, and redness, as well as nipple inversion and an orange-peel-like texture to the skin.

Take a selfie

A self breast exam is a way for women to inspect their own breasts for any changes or lumps.  Breastcancer.org has a great Five Step Self Breast Exam that is easy to follow and offers thorough instructions.  Women can begin giving themselves self breast exams as early as their 20s and can continue to do so as long as they are in good health.  Even after beginning regularly scheduled mammograms and clinical breast exams, women can still periodically give themselves a self breast exam in between regularly scheduled appointments.  If you are unsure of how to do a self breast exam or what to look for, ask your physician during your next breast exam.

Genetic Testing and Counseling

Sometimes, a family history of breast cancer could be related to genetics, specifically a mutation to either the BRCA1 or BRCA2 genes.  The BRCA1 and BRCA2 genes produce tumor repressor proteins that help repair damaged DNA and stabilize genetic material in the cells.  When either of these genes are mutated, there is a greater chance that cancer may develop.  For the general population, about 12% of women will develop breast cancer at some time during their life.  For women who inherit a BRCA1 mutation, 65% will develop breast cancer by age 70, and 45% of women who inherit a BRCA2 mutation will also develop breast cancer by age 70. 

Genetic testing can determine whether a BRCA1 or BRCA2 mutation exists in an individual by analyzing a sample of blood and looking for abnormalities in these genes.  Genetic Counselors can help someone to determine their genetic risk of developing cancer and decide if that person is a candidate for genetic testing.  They can also help individuals to better understand their test results after genetic testing is done.  Factors that may play a role into whether or not an individual may be a candidate for genetic testing include:

• Family history of cancers, such as breast cancer, that are linked to a single gene mutation.

• Family members who have had cancer at a younger age than is typical for that type of cancer.

• First degree relatives (i.e. parents, siblings, and children) with cancer, especially the same type of cancer.

• A family member who has already had genetic testing and found to have a genetic mutation.

For more information on genetic counseling visit the Cancer Care at Community Care Physicians website or call 518-213-0308. You can also contact OB/GYN Health Center Associates at 518-274-0476 or Upstate Hematology Oncology at Community Care Physicians at 518-836-3030, both do genetic testing and counseling.

Mammography and the Importance of Early Detection

Mammograms are an essential tool in the early detection and prevention of breast cancer.  A mammogram is the best way to detect early breast cancer, and it is the only way to detect lumps or masses that are too small to be felt.  The Breast Center at ImageCare uses the latest advances in digital mammography including 3-D mammography, or tomosynthesis.  If you would like to learn more about the benefits of mammography or would like to schedule a mammogram, you can visit The Breast Center at ImageCare website or call (518) 786-1600 for our Latham location or (518) 584-5000 for our Saratoga Springs location.  When it comes to breast cancer, early detection truly is the best protection.