october(2): Breast cancer awareness month

​DID YOU KNOW?
In 2017, it's estimated that among U.S. women there will be*:
252,710 new cases of invasive breast cancer 
40,610 breast cancer deaths
*American Cancer Society. Cancer Facts and Figures 2017. Atlanta, GA: American Cancer Society, 2017.

What is Breast Cancer?  What do you know about breast cancer?
Cancer is a disease in which cells in the body grow out of control. When cancer starts in the breast, it is called breast cancer. Except for skin cancer, breast cancer is the most common cancer in American women.
Breast cancer screening means checking a woman’s breasts for cancer before she has any symptoms. A mammogram is an X-ray picture of the breast. Mammograms are the best way to find breast cancer early, when it is easier to treat and before it is big enough to feel or cause symptoms.  
Most women who are 50 to 74 years old should have a screening mammogram every two years. If you are 40 to 49 years old, or think you may have a higher risk of breast cancer, ask your doctor when to have a screening mammogram
Some things may increase your risk:
The main factors that influence your breast cancer risk are being a woman and getting older.
Other risk factors include--
• Changes in breast cancer-related genes (BRCA1 or BRCA2).
• Having your first menstrual period before age 12.
• Never giving birth, or being older when your first child is born.
• Starting menopause after age 55.
• Taking hormones to replace missing estrogen and progesterone in menopause for more than five years.
• Taking oral contraceptives (birth control pills).
• A personal history of breast cancer, dense breasts, or some other breast problems.
• A family history of breast cancer (parent, sibling, or child).
• Getting radiation therapy to the breast or chest.
• Being overweight, especially after menopause.
Symptoms:
Some warning signs of breast cancer are— 
• New lump in the breast or underarm (armpit).
• Thickening or swelling of part of the breast.
• Irritation or dimpling of breast skin.
• Redness or flaky skin in the nipple area or the breast.
• Pulling in of the nipple or pain in the nipple area.
• Nipple discharge other than breast milk, including blood.
• Any change in the size or the shape of the breast.
• Pain in the breast
Other conditions can cause these symptoms. If you have any signs that worry you, call your doctor right away. 
What can I do to reduce my risk of breast cancer?
Many factors over the course of a lifetime can influence your breast cancer risk. You can’t change some factors, such as getting older or your family history, but you can help lower your risk of breast cancer by taking care of your health in the following ways--

• Keep a healthy weight.
• Exercise regularly (at least four hours a week).
• Research shows that lack of nighttime sleep can be a risk factor.
• Don’t drink alcohol, or limit alcoholic drinks to no more than one per day.
• Avoid exposure to chemicals that can cause cancer (carcinogens) and chemicals that interfere with the normal function of the body.
• Limit exposure to radiation from medical imaging tests like X-rays, CT scans, and PET scans if not medically necessary.
• If you are taking, or have been told to take, hormone replacement therapy or oral contraceptives (birth control pills), ask your doctor about the risks and find out if it is right for you.
• Breastfeed any children you may have, if possible.

If you have a family history of breast cancer or inherited changes in your BRCA1 and BRCA2 genes, you may be at high risk for getting breast cancer. Talk to your doctor about more ways to lower your risk.
Staying healthy throughout your life will lower your risk of developing cancer, and improve your chances of surviving cancer if it occurs.

What should you do?
I currently recommend breast self awareness.  This means that you know your own breasts.  You look at them in the mirror and check for any changes in the skin or shape.  You should feel your breasts periodically, if you are still having periods, it is best to do so after your period because the breasts are less tender and "lumpy" at that time. You can do this check standing up or lying down or both.  It is good to check them both ways because there are different factors affecting what you are able to feel in those positions.  Maybe alternate checking in the shower one month with in bed the next... 
What are you feeling for?  Well, initially I suggest that you just get an idea what your breasts feel like.  You may or may not be able to feel your ribs depending on the size of your breasts.  It is likely that you will feel differences in texture throughout your breasts. 
​Oh, I want to be sure to remind you to include your underarm and the tail of the breast which extends between your breast and armpit as shown in these pictures, the breast tissue and the lymph nodes around it extend beyond what many of us think of as our breasts.​

If you feel a lump in your breast, try not to panic or worry. Most lumps are not breast cancer, but something less serious, such as a benign (not cancer) breast condition.  Most common are cysts or inflamed ducts and lymph nodes from other irritants.
However, if you find a lump (or any change in your breast or underarm area), it's best to see a doctor to be sure it's not breast cancer.
Currently, several agencies have determined that the evidence for breast self exam or examination of the breasts by your doctor for screening purposes is not sufficient to recommend them.  This means that the data and statistics don't show enough cancer is found that way to make it cost effective and there are more "false positives" leading to work up for something that is not cancer and would probably go away on it's own.
I am still happy to do an annual breast exam during your well woman check up. 
Also, if you ever have symptoms of concern as listed above or feel something that has changed during your breast awareness checks please come see me or your regular doctor to have it checked right away!
As mentioned above, Mammograms are definitely recommended.
Whether you should have one every year or every other year is something that needs to be discussed with your doctor.  Additionally, when to start your mammogram testing is an individualized discussion.  For low risk women, the current recommendation is every other year from 50 to 75.  I am happy to take the time necessary to review your history and help you to make an informed decision regarding these issues if you are one of my patients, otherwise, please have this conversation with your doctor.

​Questions, concerns, comments?
Please feel free to comment below.  I am excited for the opportunity to share information and my expertise and experience with you.

​Are concerned that you can’t afford a mammogram? 
If you have a low income or do not have insurance and are between the ages of 40 and 64, you may qualify for a free or low-cost mammogram through CDC’s National Breast and Cervical Cancer Early Detection Program. To learn more, call (800) CDC-INFO
If you have any questions about how to care for your body, including your breasts please feel free to make an appointment to see me or your primary care physician.
​Website sources for photos and information: the CDC, Susan G Komen foundation, nationalbreastcancer.org, breastcancer.org, theartguts.com