Golden Opportunities

October is Breast Cancer Awareness Month, and that means more than just wearing a pink ribbon. For women, it means making sure you’re up-to-date on your cancer screening. Here to explain why early detection is so vital is Dr. Mary Murray, a breast surgical oncologist at Akron general Medical Center.

Question: How often should women receive a mammogram?

Answer: Women should start getting mammograms every 1-2 years at age 40, and every year after age 50. October, thanks to the Awareness Month, is a great time to do so, because many institutions are offering free screenings at this time.
The early signs of breast cancer cannot be felt. By the time the lump reaches 1 centimeter, it may have already doubled 100 billion times, and been present for 10 years. Mammograms find early breast cancer that may not have yet left the ducts. The earlier the cancer is found, the greater the chance for survival.

Question: If a mammogram finds something suspicious, what happens next?

Answer: Calcifications can be a marker for cancer. Calcifications that are grouped together in a certain way, or have a pattern that appears to follow breast ducts can be early signs of breast cancer.
If found, you may have a stereo tactic biopsy. This is a technique in which a special mammogram is taken, and a computerized model accurately targets the calcifications within the breast. This allows the surgeon or radiologist to guide a hollowed-out needle into the area of calcification.
This allows us to biopsy and sample the calcifications and surrounding breast tissue. It is done on an outpatient basis, and the procedure takes usually less than 30 minutes after the lesion is targeted. Only a small nick is made in the skin to allow needle insertion, which is easily re-approximated with a Band-Aid.
This is an excellent procedure as it is minimally invasive and leaves a very tiny scar. The good news is that 8 out of 10 calcifications are benign.
A mass (lesion or tumor) may be discovered. Again, it may be benign or cancerous. An ultrasound may be used to aid in the biopsy of the mass.
If cancer is found on the biopsy, then treatment plans can be discussed with the patient. (Mastectomy with or without reconstruction or lumpectomy and radiation can be considered.)

Question: What do you say to someone who is reluctant to have a mammogram?

Answer: If you are not receiving a mammogram because you are afraid of finding something, ignoring the situation won't make it better. Finding cancer early is so important to survival.
Some avoid mammograms due to fear of pain. It's not painful, but there may be discomfort. If you are still menstruating, planning the exam shortly after your period will help.
The pictures, and therefore the compression, last 1-2 minutes each. The total exam generally takes approximately 20 minutes

Question: Are self-exams still necessary? What should you look for during the examination?

Answer: Self-exams are very important. Most women are lumpy and bumpy naturally in their breasts, so it's good to get used to what is normal for you by doing a self exam every month. If you are part of a high-risk family, you should receive an exam from a clinician yearly as well. However, an annual clinical examination would be a good rule for any female 20 or more years of age.
Benign lumps move around and are rubbery to feel, but if you are suspicious of anything, call your physician.
Look for lumps under the armpits as well as changes in the nipple.
Look for changes in the skin-inflammation or thickening of it. Inflammatory breast carcinoma is a type of breast cancer that does not show up on a mammogram but rather looks like a rash (and is often misdiagnosed as such).

In July it's sunscreen that's important. In October it's screening for breast cancer! For more information on breast cancer awareness, give Akron General a call. My thanks to Dr. Mary Murray.