Search Here
Breast cancer is now the most common cancer in the world. In fact, 12% of all new cancer cases in 2021 will be breast cancer. As a result, chances are you know someone who has faced this terrible disease. And it is likely you have wondered about breast cancer screening.
Currently, there are several recommendations about breast cancer screening. There are benefits to screening and early detection, but there are also potential problems. Your doctor should help you decide which tests you need based on your history and risk. For high-risk men and women with a family history of cancer, BRCA genetic testing is invaluable.
Breast cancer screening is a great way to take charge of your health. Here's what you need to know about breast cancer screening.
According to the National Cancer Institute, screening means looking for the disease before there are any signs. Hence, the best time to get checked is before you have symptoms.
Screening is looking for abnormalities. It may find cancer at an early stage. Because of advanced detection, doctors can more easily treat the disease. Patients also have better odds at survival. Each type of cancer has unique guidelines for screening.
Overall, current guidelines and recommendations say that most women should have a mammogram to detect tissue changes beginning at age 40.
Men are also affected by breast cancer. However, most guidelines do not include them in the recommendations. A doctor can give male patients personalized guidelines for screening.
Here are the most current routine recommendations for women starting at age 40.
| Organization | Women Age 40-49 | Women Age 50-74 |
| US Preventive Services Task Force (USPSTF) | Individualized to the patient | Digital mammogram every 2 years |
| American College of Obstetricians and Gynecologists (ACOG) | Offer annual mammogram | Mammogram every 1-2 years until age 55, then every 2 years |
| National Cancer Institute (NCI) | Mammogram every 1-2 years | Mammogram every 1-2 years |
| American Cancer Society | Offer annual mammogram until age 45, then mammogram every year | Mammogram every year age 50-55, then every two years after age 55 |
| American College of Radiology (ACR) | Annual | Annual |
Some men and women worry about breast cancer because they have a family history of cancer.
Women with a personal or family history of some cancers could have changes in their genes. These mutations are known as BReast CAncer gene 1 (BRCA1) or BReast CAncer gene 2 (BRCA2) changes. They may mean a higher cancer risk.
High-risk patients should see a doctor or specialist. They will need a risk assessment, genetic counseling, and in some cases, lab testing. Mutations in the BRCA1/2 genes may lead to:
Genetic testing for BRCA1/2 requires a special blood test that your doctor can order. The doctor can explain the details. They can also answer questions you might have.
According to the National Cancer Institute, many women with ovarian and breast cancers are not receiving these genetic tests, even though they have become inexpensive and easily accessible.
Now with telemedicine, it is easier than ever to get this valuable testing done. An online provider such as a virtual gynecologist or virtual physician can tell you if you need it and when or how to get it.
My Virtual Physician offers consultations about this important BRCA gene testing. For little or no out-of-pocket cost, they can arrange for you to have your blood drawn. They make it easy. They work with many local LabCorp or Quest outpatient testing centers who can provide this service for you.
Like much in healthcare, tests may not be “one risk fits all.” That is why you should talk to your doctor about what is best for you. He or she will consider factors such as lifestyle, family history, and other health concerns. Then they can help you decide what to do.
Your doctor can recommend one of these methods below. If you do not have a doctor, a virtual doctor online can be a great place to start.
The most common test for breast cancer is called mammography. It is ordered by a doctor. Mammograms look for early changes in the tissue that could be dangerous.
A mammogram is a special type of X-ray that shows the breast tissue. Sometimes, doctors can see lumps on the images that they cannot feel.
Women who have a high risk of cancer or have dense breast tissue may require magnetic resonance imaging.
The MRI test is more sensitive and can detect finer irregularities. MRI images also give a clearer picture of the breast tissue. Unfortunately, this screening method is much more expensive and therefore is not used for routine exams.
Breast cancer testing is an active area in clinical research. Other methods include:
Physicians can explain the options to patients. And they can help them make informed choices about each type of screening.
Doctors can help guide a patient to the best choice. Physicians also tell their patients about risks that they need to consider.
Your doctor should tell you when to get screened for breast cancer. Talking to a board-certified physician about the right time for you to have a cancer screening may prevent problems.
Specialists caution patients that there are risks involved with all medical tests, including cancer screening. Some of them include:
This is why you should talk to your doctor when you are thinking about breast cancer screening.
My Virtual Physician offers a full line of virtual physician services. To talk with one of our board-certified physicians, click to book now. Our caring experts can talk with you about a screening plan that is best for you.
If you have suggestions for other topics you want to read about, let us know! Don’t forget to follow us on social media.
Sources:
Breast Cancer Overtakes Lung As Most Common Cancer - WHO. Reuters. Feb 2, 2021. https://www.reuters.com/article/health-cancer-int/breast-cancer-overtakes-lung-as-most-common-cancer-who-idUSKBN2A219B
Cancer Screening Overview (PDQ®)–Patient Version. National Institute of Health. National Cancer Institute. Aug 19, 2020. https://www.cancer.gov/about-cancer/screening/patient-screening-overview-pdq
Breast Cancer Screening. U.S. Preventative Task Force. Jan 11, 2016.https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening
Breast Cancer Risk Assessment and Screening in Average-Risk Women. American College of Obstetricians and Gynecologists. Practice Bulletin. Number 179. July 2017. https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2017/07/breast-cancer-risk-assessment-and-screening-in-average-risk-women
American Cancer Society Guidelines for the Early Detection of Cancer: Breast Cancer. American Cancer Society. Jul 30, 2020. https://www.cancer.org/healthy/find-cancer-early/american-cancer-society-guidelines-for-the-early-detection-of-cancer.html
New ACR and SBI Breast Cancer Screening Guidelines. American College of Radiology. Apr 4, 2018. https://www.acr.org/Media-Center/ACR-News-Releases/2018/New-ACR-and-SBI-Breast-Cancer-Screening-Guidelines-Call-for-Significant-Changes-to-Screening-Process
BRCA Overview. Basser Center for BRCA, Penn Medicine. Accessed Jul 24, 2021. https://www.basser.org/brca
Chen, S., Parmigiani, G. (2007). Meta-Analysis of BRCA1 and BRCA2 Penetrance. Journal of Clinical Oncology, 25(11), 1329-1333. https://doi.org/10.1200/JCO.2006.09.1066
Fewer Women with Ovarian, Breast Cancer Undergo Genetic Testing than Expected. National Cancer Institute. Apr 9, 2019. https://www.cancer.gov/news-events/cancer-currents-blog/2019/ovarian-breast-cancer-testing-inherited-genetic-mutations
BRCA1 and BRCA2 Testing. BreastCancer.org. Sep 21, 2020.https://www.breastcancer.org/symptoms/diagnosis/brca
Pediconi, F., & Galati, F. (2020). Breast cancer screening programs: does one risk fit all?. Quantitative imaging in medicine and surgery, 10(4), 886–890. https://doi.org/10.21037/qims.2020.03.14
Stefanie (00:00):
The information presented in this podcast is offered for educational purposes, only presenting it is not intended to and does not create a provider-patient relationship between any presenter and anyone else about the medical topics addressed presenters provide general information only not diagnosis or recommended treatments or any other information specific to any individual listeners are encouraged to see their own healthcare professional about all topics address on talk Tuesdays or for any other medical problem. [inaudible] welcome everyone. Thank you for joining us today. My name is Stefanie and I'm part of the team here at My Virtual Physician. We are a direct to consumer multi-specialty telemedicine provider operating in multiple States. It is Talk Tuesday and we are continuing our weekly educational series to talk with our experts, explore some common healthcare concerns that we see and hopefully answer some questions you may have today. Our physician expert is Dr. Coleman. She is a general surgeon, and today we are going to talk about breast cancer surgery. So thank you
Dr. Ginger Coleman (01:14):
Joining us today. Thanks for having me. Yeah. And welcome back. Okay. So after the biopsy, they told me that I have cancer. So now what, so there's a bunch of different types of cancer. So the first thing will depend on what kind of cancer you have and how big it is, and if lymph nodes are involved. So, so don't panic, there's, there's a lot of options for surgery and every option would be something that you would need to discuss with your personal physician and determine what the best course of action is for you and your particular type of cancer. But, but we'll discuss a couple common options. Um, there's something called breast conservation surgery also known as a lumpectomy or a partial mastectomy. So this is where a small ish incision is made. It's not necessarily right over where the area of cancer is. We try and hide the incisions.
Dr. Ginger Coleman (02:22):
So sometimes we may put it around the nipple. Sometimes we may put it and underneath the breast, sort of in the, in the fold, sometimes we gotta just make an incision across your skin and we try and hide it as best as we can, but it doesn't happen all the time. Essentially, once we make that incision, we remove a small portion of breast where the cancer is as well as some normal breast tissue surrounding it. And in order to do that, because if you had a lesion that wasn't palpable, it was just something abnormal seen on your mammogram. Obviously, we can't it in the, or so we have to have our radiologists localize it for us, what used to be done. And it's still done in a lot of places, but we're moving away from it is what's called a wire localization and you would go to mammography before surgery.
Dr. Ginger Coleman (03:20):
The radiologists would do another mammogram and they would find that area of concern. And then they stick a little wire into the lesion. So we're trying to get away from it because it's not real fun to be wheeled around the hospital with a wire sticking out of your breast, waiting to go to surgery. But that wire is directed to that area where you have cancer or the area of concern that needs to be removed. And they give us mammogram images to use in the operating room to make sure that we know where that is. So, so we'll excise that area more recently, they've moved to using things like radioactive seeds that can be placed by the radiologist and they can, they can be done a couple of days before surgery, some even up to a couple of weeks before surgery. So it's not something you have to come in that day and get done.
Dr. Ginger Coleman (04:10):
You can get it done kind of on your own time, leading up to surgery. And then in the operating room, we use a little, I call it the Geiger counter, but it's a little probe that beeps when you get close to the, the seed or, or whatever it is that they used, there's a whole bunch of different kinds. And, and so that helps locate the area of cancer. And then that gives us an idea and we remove that portion of tissue. And then, like I said, some normal breast tissue around it. And depending on the type of cancer you have will determine how much breast tissue we need to take. And depending on, you know, if you have DCIS or you have invasive cancer, that will also determine if we need to take any lymph nodes from your XLO also known as your armpit. Okay.
Dr. Ginger Coleman (04:59):
So then you said there were more than one type. So what's the other. Yes. And the other type is a mastectomy and that's where your whole breast is removed. There are different types of mastectomies. A simple mastectomy is probably what most people are familiar with. And that would be where all of your breast tissue and your nipple and areola are removed. And you have just a flat chest after that, on that side, there's something called a modified radical mastectomy. And that's a simple mastectomy, except during this operation, all of the lymph nodes in your Exela are removed that's surgery. There's some other mastectomies, a nipple-sparing mastectomy, and skin-sparing mastectomies that are also options. I won't really go into those, but, but really any mastectomy that's done can be followed with breastfeeding plastic surgeon, either during the same operation or at a later date. It all depends on the type of cancer you have and what other treatments that you need after surgery and understanding that there are risks and benefits of each type of surgery and what may be best for you may not be, you know, what you really desired to have done. There's if you need radiation after having a mastectomy, you don't really want to have reconstruction because you're not going to heal and you're going to have more problems and need more surgery. You may not have any complications, but do you want to risk it? So even after a mastectomy, you can get reconstruction, you can get it done that day, and we do that pretty frequently, but it all depends on you in particular, what's going on with you and what treatments that you need.
Stefanie (06:59):
Yeah. Um, so then you S you said lymph nodes. And can you talk to us a little bit about that or why they're removed?
Dr. Ginger Coleman (07:08):
Yeah. So your lymph nodes often are, are said to quote unquote, filter your blood. And so if you have breast cancer that is going to drain into your lymphatic system, and we'll go through those lymph nodes. And usually if you have breast cancer on the right side, you look in the right armpit for the lymph nodes and see if you can feel any that are, you know, big or thick and kind of mad at or anything. And even if they feel normal, it doesn't mean that there's not tumor in them. So if you find tumor in those lymph nodes, it's a sign of metastatic disease and it's more affiliated with invasive cancer. And so that's why it's important for us to evaluate the women, especially in invasive cancer. And you can do it in two ways. Again, there's two ways, there's something called a Sentinel lymph node biopsy, or you can have an auxiliary dissection.
Dr. Ginger Coleman (08:07):
So with a Sentinel lymph node biopsy, you can do this with either breast conservation or a mastectomy. If you do it with breast conservation, it's a separate incision, and it's not real big. We try and hide it in the, you know, one of the creases in your armpit or at the hairline, just to kind of hide the scar, but it is a separate incision. And we go through there to find the lymph nodes. If you do the lymph node biopsy with a mastectomy, it's all through the same incision. So you don't have two separate incisions prior to surgery. You usually go to a nuclear medicine department and get this radioactive tracer injected. And then in the operating room, we use a blue dye, methylene blue. I just often blue something and we inject and everyone does it a little bit different, but we always injected it underneath the nipple, or I'm sorry, underneath Ariel.
Dr. Ginger Coleman (09:03):
And then you do your surgery and, and the axilla is the last thing that you do. So by the time you get there, hopefully all that blue dye has made it swaying to your lymph nodes. And so we use that little Geiger counter thing again, and it helps you find that radioactive tracer, but then we're also looking for blue. So what we want to do is find the blue and radioactive lymph nodes and remove those. And the machine will give you a number and you want to take the highest number because that's theoretically the lymph node that drained first or the Sentinel node. And we usually take about three more or less. It kind of depends on what we see in there. If it's very obvious that all of your lymph nodes are involved, you may then end up with an axillary dissection and not just the Sentinel lymph node biopsy.
Dr. Ginger Coleman (09:57):
So an axillary dissection is actually where all of the lymph nodes are removed. Usually we do this with a mastectomy, so like the modified radical mastectomy, and it's all through the same incision. Sometimes you can do it after a lumpectomy or any other surgery that you've had, or Sentinel lymph node biopsy. If that biopsy came back with signs of invasive cancer that eat, that indicated you you'd need all of the lymph nodes removed. So then we would have to go back and do another operation, but usually we do it with a mastectomy. So it's all one surgery. And we just take out all of those lymph nodes. There are some nerves and blood vessels in the area that are important that we don't disrupt. They can cause some, you know, numbness or tingling of your arm or difficulty moving your shoulder, or even make your shoulder blades stick out.
Dr. Ginger Coleman (10:56):
But injuries to those nerves are not really common. Okay. So then you did your mastectomy or lumpectomy. So what happens after surgery? So depending on the type of surgery you had, you'll either go home that day or you'll stay overnight in the hospital. And usually nobody has to stay more than 23 hours or no more than a day. If you, if you had a lumpectomy and you don't have any serious medical conditions or anything that would be of concern, usually you just go home. So someone will, someone will need to drive you home. And we'll see you in clinic in a couple of weeks and let you know the pathology. If you had a mastectomy, you usually stay in the hospital, at least overnight, uh, you will have a drain or two, depending on if you had to have an axillary dissection or not. Um, and, and every surgeon is different with how they do it, but, but usually you will have at least wondering.
Dr. Ginger Coleman (11:58):
So we'll teach you how to take care of that. We keep you overnight to make sure that there's not a lot of bleeding out of the drain or anything that would be concerning to need to take you back surgery. Uh, if you do, okay, you go back home and then you see us in clinic and we'll take the drains out in clinic and talk about pathology. Uh, and, and if you haven't seen an oncologist already, we'll send you to one. Um, usually they're the ones that send you to us. So that's, that's usually pretty well organized, but that's when you would talk with them about the need for chemo or radiation. And sometimes if, you know, we do breast conservation surgery and maybe we didn't get all of the cancer, it'll be called, you know, you have positive margins. And so at that time, we would have to talk about going back for either re-excision of those areas that were positive and depending on your breast size and the type of cancer you have and all of that, it, it may end up being okay, well, now we need to talk about actually doing mastectomy because the pathology showed whatever it showed, but there is a possibility that you, that you would have to go back to surgery if you do breast conservation.
Dr. Ginger Coleman (13:15):
And it doesn't happen all the time, but it is, you know, one of the risks of trying to preserve the breast tissue.
Stefanie (13:23):
Um, thank you so much, dr. Coleman. I know it's a really hard topic to talk about. Cancer is always something that's pretty scary word. I appreciate you joining us for Talk Tuesday and telling us what we need to know about breast cancer screening and breast cancer surgery for everyone else. Joining us as well. This has been Talk Tuesdays with my virtual physician. You can schedule a consultation with one of our doctors by visiting our website at www.myvirtualphysician.com. We look forward to seeing you again, and we hope you have a great week Nation presented in this podcast is offered for educational purposes, only presenting it is not intended to and does not create a provider-patient relationship between any presenter and anyone else about the medical topics addressed presenters provide general information only not diagnosis or recommended treatments or any other information specific to any individual listeners are encouraged to see their own healthcare professional about all topics address in Talk Tuesdays or for any other medical problems.
Speaker 1:
The information presented in this podcast is offered for educational purposes, only presenting it is not intended to and does not create a provider-patient relationship between any presenter and anyone else about the medical topics addressed presenters provide general information only not a diagnosis or recommended treatments or any other information specific to any individual listeners are encouraged to see their own health care professional about all topics address on Talk Tuesdays or for any other medical problem.
Speaker 1:
Welcome, everyone. Thank you for joining us today. My name is Stephanie and I'm part of the team here at My Virtual Physician. We are a direct to consumer multi-specialty telemedicine provider operating in multiple States. It is Talk Tuesday and we are continuing our weekly educational series to talk with our experts, explore some common healthcare concerns that we see and hopefully answer some questions you may have today. Our physician expert is dr. Coleman. She is a general surgeon, and today we are going to talk about breast cancer screening and breast cancer surgery. So thank you for joining us today. Thanks for having me. Yeah. And welcome
Speaker 2:
Back October was breast cancer awareness month. So we're going to be doing
Speaker 1:
Again a blog and an episode or two of Talk Tuesday on breast cancer screening. When would someone go in to get a mammogram or if they feel something or they have any history of breast cancer in their family, what's kind of the age range,
Speaker 2:
What to look for. Okay. So there's actually three organizations, probably more, but there's at least three organizations that have opinions on breast cancer screening, depending on which organization you listen to, it could be 40 years old, 45 years old or 50 years old, either way. Everyone agrees that by the age of 50, you should be getting a screening mammogram, most people, uh, and I believe most insurance companies go with the age of 40 breast cancer. Under the age of 40 is pretty rare. If, if you have
Speaker 1:
Breast cancer under the age of 40, usually it's associated
Speaker 2:
With some sort of genetic predisposition. There's the BRC mutation that predispose people to, to breast cancer at a younger age. But there's some other things that can, can run in families. Some other genetic diseases that predispose you at a younger age and typically cancer at a younger age is more aggressive and more advanced when it's found, because who in their thirties thinks that they're going to have breast cancer. So what we learned in residency was at the age of 40, you started getting your screening mammograms, and that's just, you have no symptoms. You have nothing going on. You're 40 years old. It's time to get a mammogram. Just like when you turn 50, you got to get a colonoscopy. It's just a way of life. Some people will come in. Well, I feel a mass I'm worried. And this also kind of depends on your age.
Speaker 2:
If you're younger, the chances of you having a mass that's breast cancer is pretty low. You, you may have these little hard nodules called fibroadenomas. They're pretty common in younger people and they grow and shrink in size with your menstrual cycle. And that's something that people usually will point out like, Oh, I noticed this, I know I was on my period last week and now I don't really feel it so much. And so that's, that's pretty common and we can actually do ultrasounds in clinic. I mean, not everyone, but if you're, if the clinic has an ultrasound, we can do an ultrasound because sometimes it's just breast cyst that can feel like a lump and they can hurt. And if it is a cyst, they can drain it in the office and, and hopefully give you some relief. So when you turn 40, get a mammogram, if you feel something that's concerning, you would need to go into your doctor, talk to them about getting an ultrasound or a mammogram.
Speaker 2:
And again, depending on your age, it may dictate what screening that they do. If you have a family history of breast cancer, then that would be something to coordinate with your doctor to get a screening done earlier. They usually recommend doing screening before 40, uh, it may be an MRI and mammogram alternating every six months starting at the age of 25 30. It just kind of depends on when your family member had breast cancer and what genetic mutation it is that you have. So I've had my screening mammogram and I got called back in for more images, do I have cancer? So not necessarily, this is something we actually deal with quite a lot. It really kind of depends on your age and your breast tissue density. It can be really hard to evaluate the breast tissue on a screening mammogram. If you have really dense breast tissue, there's actually, uh, States that have a requirement when they report on your mammogram, that they disclose to you that there are certain regions, depending on the density of your breasts, that they may not be able to see.
Speaker 2:
So they have to give you that information because then if you end up having breast cancer, but you've, you've had a screening mammogram, you know, why wasn't it caught well, and it, it can just really depend on the density of your arrests. So sometimes you'll get a call that you need to come back in and it's for a more formal or what we call a diagnostic mammogram. The difference in that is with a screening mammogram, you kind of just, you go into a facility, they do the mammogram and you go home. And in a couple of days, they either call you with the results or you go into your doctor's office and they give you the results, a diagnostic mammogram, you go into a facility, but the radiologist is, is physically there. And when they do the mammogram, they try and focus on that area that was questionable in your screening mammogram.
Speaker 2:
And so the radiologist can actually look at it in real-time and determine, okay, well, we need a different view here, or we need to zoom in here and take a better look at that so that you don't get called back in for even more. This is, I'm a little bit better idea of, of what they're looking at. And if it, if it is something that looks suspicious for cancer or not, some patients may actually end up needing an ultrasound to go with their mammogram or an MRI. It's all pretty personalized. So it all just depends on what your breast tissue looks like and what, what exactly it is, that's going on, what was seen, or if you're having symptoms and things like that. So it could just be that you have dense breast tissue, and it does not look abnormal when they do the more focused imaging, or could be something that, that is concerning for breast cancer. But being called back does not mean that you have cancer. You could, but they just need to get better pictures. Yeah.
Speaker 1:
Since so, after I got called in my mammogram showed an area concerning for breast cancer and I need a biopsy. Can you explain what that is?
Speaker 2:
Yeah. So when you need a biopsy, it doesn't necessarily mean that it's cancer again. So, so don't panic, but chances are, they saw something that are concerning and suspicious for cancer, and chances are it is, but I need a tissue sample to say for sure what it is. There's different types of breast cancer, there's DCIS, which maybe you've heard of, or there's invasive cancers by doing the biopsy. It gives you a little sample of tissue to be able to determine what type of cancer it is, what hormone receptors it has if it has any. And, and that helps you tailor your treatment, not only for surgery, but if you need chemo or other things, or even additional surgery, when you meet a bias, it can be done a couple of ways, the most common way, or at least the way that I'm used to it being done from when I was in residency is if you have a mask that can be felt if you came in because you had an that you found and you get a mammogram and they, they say, we need to biopsy.
Speaker 2:
If they can see it, then you can get a biopsy done with an ultrasound and you don't have to go through a mammogram again. If you can't see it on an ultrasound, then you got to get a mammogram again. So not, not super fun for everybody when they do it with under a mammogram, it's done by a radiologist typically, and it's called a stereotactic biopsy. So essentially you lay down on this table and you lay face down and there's, there's a little opening in the table. And the breast with the concerning area goes through this little hole in the table and kind of hangs blue so that the arm on this machine can get in the right position and orientation to access the delusion that the arm on the mammogram machine has a needle on it. And once the area is targeted, the needle goes in, they take a sample of the breast tissue that comes out, but there's also a clip that gets placed in the area that they biopsied.
Speaker 2:
So that on later imaging, you can say, okay, well, we already biopsy this area and everything was normal. Or this is where they had a biopsy before we don't see anything different. Or, you know, now there's something there that, that wasn't there before. And we need to re-investigate it. Sometimes you can't do the stereotactic biopsy and that's for reasons, you know, maybe you can't lay flat, maybe it's too uncomfortable, or you can't breathe. There are weight limitations. And depending on your age, I mean, it may just not be something that you're very capable of laying there because it's not, it's not a five-minute procedure. I mean, it's a 20-minute procedure or so. And it depends on where the lesion is. If it's really close to your chest wall, like the muscles underneath your breasts, they don't usually do the stereotactic biopsy. They can still do a biopsy under a mammogram. It's just done a little bit differently. This is all kind of targeted and oriented and one process. Whereas if they have to do it with, without the stereotactic part, it's done a little bit differently. Now there are some stereotactic biopsy machines where you can actually sit up. I don't know how many places have those. Like I don't, I'm not real familiar with how prevalent they are, but they do exist. So that maybe something that they could do.
Speaker 1:
Thank you so much, Dr. Coleman. I know it's a really hard topic to talk about. Cancer is always something that's a pretty scary word. I appreciate you joining us for Talk Tuesdays and telling us what we need to know about breast cancer screening for everyone else. This has been Talk Tuesdays with My Virtual Physician. You can schedule a consultation with one of our doctors by visiting our website: www.myvirtualphysician.com. We look forward to seeing you again, and we hope you have a great week.
Speaker 1 :
Information presented in this podcast is offered for educational purposes, only presenting it is not intended to and does not create a provider-patient relationship between any presenter and anyone else about the medical topics addressed presenters provide general information only not a diagnosis or recommended treatments or any other information specific to any individual listeners are encouraged to see their own healthcare professional about all topics addressed on Talk Tuesdays or for any other medical things.
As temperatures cool and leaves begin to change, we are beginning to see the colors of fall all around us. The golds, deep reds, and pink signal that October is upon us. The pink ribbon has become an international symbol for breast cancer awareness. And this month serves as an annual campaign to promote action in the fight against the disease. To kick off breast cancer awareness month, here is some important information on the importance of breast cancer screening, that could even help save a life.
Breast cancer screening is routine testing for healthy people that are not showing any symptoms or having any problems. There are different types of screening tools and tests, and your physician can help determine what is best for you.
There are several different screening tests that providers can use to check for breast cancer. For example, clinical breast exams are sometimes part of annual wellness visits. Another example is thermography which uses an infrared camera to view heat patterns and blood flow in body tissues. A third example of a breast cancer screening test is mammography. This is the type that most people are familiar with. So what exactly is mammography?
Mammography is a procedure that uses a low dose x-ray to show the inside breast tissue. It gives us a mammogram, similar to a photograph of the internal breast tissue. Mammography can visualize lumps that cannot be felt by physical exam. Furthermore, in some cases, mammography may detect changes in the breasts that could be cancerous years before symptoms would appear.
Mammography is a somewhat newer technology. It was introduced in the United States in the 1980s. Notably, since that time, deaths from breast cancer among women have decreased by 30%.
The recommendation for routine screening varies from person to person. Breast cancer can affect men but the risk is low. The vast majority of women are at average risk of developing breast cancer. This means that their risk is less than 15 percent of developing breast cancer in their entire lifetime. Still, others might be considered high risk. For this reason, it is important to talk with your healthcare provider about what is right for you. When you talk with your physician, they will discuss your screening options.
Recent studies warn against overdiagnosis. Overdiagnosis may represent 20% or more of all breast cancers among screen-detected cancers. Overdiagnosis leads to overtreatment and inflicts considerable physical, psychological, and economic harm to many women.
This term overdiagnosis refers to cases where breast changes discovered during examination are diagnosed as cancer, but would never have caused any problems or evolved, had they not been found on screening. This is an example of why it is vital for individuals to understand the risks and benefits of screening. There are risks and limitations for every test.
Because the incidence of cancer in women under the age of 40 is so low, it is recommended to avoid testing before that time. This is one way that overdiagnosis can be mitigated. Newer studies show that cancers diagnosed at an earlier age can be more aggressive. Therefore early detection is important. The American Cancer Society recommends annual screening starting at age 40.
Although there are some risks with screening as we mentioned, routine screening offers important benefits including early detection and early intervention. It is recommended that women without any risk factors should still be screened. This is because up to 75% of breast cancer cases are diagnosed in women who have no risk factors at all.
Early detection is important. Firstly, early detection helps with a diagnosis before symptoms appear. Secondly, the risk of dying from cancer goes down by 25-30% or more with early detection. Without early detection, tumors can grow and possibly spread to other parts of the body. As you see, early detection is important and can lead to early intervention.
With an early diagnosis, patients have the opportunity for early intervention. This is important because cancer is usually easier to treat early in the disease process. Furthermore, treatment usually requires less aggressive therapy. More advanced cases may need extensive treatment including chemotherapy, surgery, and radiation.
Another benefit of early detection and early intervention is the lower cost associated with treatment. This is because the treatment may be less extensive or invasive. Also, treatment plans may be shorter and require fewer therapies. The prognosis is often better too.
So now that you understand what a mammogram is and why it is important, there are just a few more tips you should know when talking to your provider about this important screening test.
Firstly, it is a relatively painless and quick test. It only takes around 20 minutes. Some patients experience mild discomfort because, during the test, breast tissue is pressed between two plates. But if you are prepared and know what to expect this should not worry you.
Secondly, you may have options. In some cases, you can choose between a 2D or a 3D mammogram. 3D mammography, also known as digital breast tomosynthesis, has become more common. Yet, it is still not available everywhere. As with all tests, there are pros and cons. One benefit of this newer technology is that it may be more helpful in showing changes in women who have denser breast tissue. Individuals who choose 3D mammography may have a lower risk of being "called back" for re-examination in the case of an unclear result. However, one reason that a 3D mammogram may not be the preferred choice is a cost consideration. This newer exam can cost more and additional health insurance plans may not fully cover it.
Thirdly, some centers offer same day results. If you might be one to worry over your test findings, choosing this type of provider might be best for you.
So as you can see, the mammogram is a relatively simple, quick, and painless test for breast cancer screening. The benefits of early detection and early intervention should be weighed with the risk of overdiagnosis as you talk to your provider. Armed with the information you have now, you can confidently talk to your healthcare provider about your screening options.
If you still have questions or you would like to talk about your risk and the screening options available, MyVirtualPhysician has doctors available for consultation. If you have any suggestions for additional topics you want to read about please let us know! Don’t forget to follow us on social media.
Sources:
