Show #403 Airing Sunday, 10/14/07
The best diagnosis of breast cancer is an early one. And that means being up-to-date on your mammograms and your self exams. Here to keep us timely is Dr. Debra Pratt, a breast surgeon and the medical director of Fairview Hospital's Breast Health Center.
Question: Despite all the news about breast cancer, fewer women have been having Mammograms. This doesn't sound like good news. What's happened?
Answer: In 2004, the most recent statistics to date, there was a 1-2% decrease in mammograms across the nation. The decrease in mammograms means that an estimated 3000-4000 cancers were not diagnosed that year, but rather diagnosed at a later time.
Economics may be a reason as to why the decrease in mammograms occurred. However, that should never be the reason. There is a lot out there in the way of grants and free mammograms, if one is in need.
In 1999-2000, there was a lot of press stating that mammograms didn't work, and that could also have affected the numbers. Many rebuttals occurred, but those did not grab the same big headlines. The rebuttals stated that, if you followed the study out for 10 years, mammograms showed a 20% reduction in mortality. So getting a yearly mammogram is very important!
Question: Are self-exams enough? Or, if you have a mammogram, can you forget about self-exams?
Answer: There should be three types of examinations of one's breast— exam by the doctor, self exam, and the annual mammogram. Mammograms can spot cancer early, yet 10-15% of all breast cancers are felt, not seen on the mammogram. You must do both!
Question: Do you have to have a mammogram every year?
Answer: Yes. Everyone's breast tissue is different, and cancer is diagnosed when technicians notice small, subtle changes over time. These subtle changes are more recognizable when a mammogram is done on a yearly basis.
Question: What do you tell people who might be afraid of pain or the biopsy process?
Answer: Compression during mammograms is necessary to get a good picture of the breast tissue, and decreases radiation. There are things that can be done to minimize the pain. If you are still having your period, don't have the mammogram the week of your period, when your breasts are tender. You can take Tylenol beforehand. You can also ask the technician to compress slowly— this often hurts less.
The biopsy can happen outside of the operating room for 70% of cancers. With an ice pack and some Tylenol or Advil, some say they feel no pain at all.
Question: What are some of the risk factors for breast cancer?
Answer: Risk factors include a family history of breast cancer, having your first child over the age of 30, having no children at all, having your first period under the age of 12, still having your period after the age of 55, and the prolonged use of estrogen replacement therapy.
Obesity is also a risk factor, especially if a woman gains 20 percent of her pre-menopausal weight in post-menopause.
Alcohol use is also a risk factor, especially if you have more than 7 drinks each week. Those who drink 4-5 glasses of alcohol a day have a 40% increase in the risk of breast cancer. About 14,000 breast cancers each year are due to alcohol intake.
If you have multiple risk factors or a strong family history of breast cancer, talk to your doctor. He/she may agree that you should avoid the daily glass of wine recommended for your heart. Alcohol in moderation is typically not a problem.
However, 70-75% of breast cancer occurs with no risk factors.
Question: And early detection truly is key?
Answer: Yes. The survival rates for breast cancer continue to go up. The diagnosis of breast cancer is not a death sentence, especially with early detection.
Get checked-and check yourself-for breast cancer. Early detection is key. To learn more, give Fairview Hospital a call at the number that's next. My thanks to Dr. Debra Pratt.
