Breast Care for Life

Stopping for a break in the climb up the narrow rocky trail along a jagged Pennsylvania mountain, my son’s large frame towered above me, but his hand steadied me, the hand of a man. What happened to the small finger that would reflexly curl around my index finger, or the tiny body that fit into the crook of my arm? This was a 20 year journey from the initial bar on the pregnancy test indicating a new life, through endless soccer games, scout meetings, homework, middle school awkwardness, to high school with daily trips to the barn for FFA, the wonderful Fort Bend County Fair, and finally graduation last May. The hope and excitement of a new beginning at college was unfolding, the journey of life.

Breast care is also a lifelong journey for each woman. The pathways of my two younger sons are different from my older son. They have different strengths and different needs. Likewise, every woman’s breast care journey will be different, as individual as the woman.

Most patients will never have breast cancer, but it’s important to be your own advocate. Know your personal risk factors whether it is a family history, dense breast tissue, or simply the two largest risk factors which are being female and getting older.

While lifestyle choices won’t prevent cancer, a healthy diet and exercise can help mitigate the risk. Regular screening is important for every woman. While the American Cancer Society recommends a baseline mammogram from 35-40 years of age and yearly mammograms after 40 years, the multiple different guidelines can be confusing. While mammogram still find early cancers, the treatment for breast cancer has improved so much that even cancers found slightly larger are often still curable.

In 2013, the Canada National Breast Screening Study showed 25 years of results where annual mammogram did not reduce mortality. This study contradicted 8 other randomized trials that collectively found a 15-30% reduction in mortality from screening mammograms. Because many breast cancers are potentially curable, many more women must be screened to prevent a death.
Additionally, mammograms will miss 15% of all cancers. A mammogram is only a single tool for detection. Breast exams are another tool. I advocate a yearly breast exam by a physician and a monthly self breast exam.

If an abnormality is found, more imaging may help to determine if it is a concern. If the area found is worrisome, it should be biopsied with a needle using the imaging to guide the needle to the correct place. A surgery is usually NOT recommended upfront. The lesion generally should be identified because most abnormalities will not need further treatment.
If you have a diagnosis of breast cancer, the treatment is tailored to your particular needs and cancer type. Today, most patients will need surgery to remove their tumor. They may also need other additional therapies called adjuvant treatment which consists of chemotherapy, radiation, and hormone blocking therapy. Treatment depends on the type and extent of the cancer and often a combination of these modalities is needed.

Every one’s breast care journey is different…as individual as their life.