Breast cancer – to stop the silent killer

Sad statistics about breast cancer

During 2018, 2 090 000 cases of breast cancer were registered in the world, 627 000 were fatal. 

In the United States, there are 279,100 cases, 42,690 are fatal.

According to the National Cancer Institute, breast cancer is the most common malignancy in Ukraine. Over the past year, 16,500 Ukrainian women were diagnosed with this oncology.

90% of all breast cancer cases are diagnosed in women over 40 years old. The maximum incidence is observed in the age range of 40–60 years.

The Ministry of Health states that cancer is curable if detected at stage I – in 95% of women, stage II – in 80%, stage III – in 50%.

Risk factors of breast cancer

Smoking
Ожиріння
Genetic predisposition
Pre-cancerous conditions
Steroid hormones
Late menopause (after 55 years)
No pregnancies
Night shifts
Alcohol abuse
Early menstruation start (before 12 years)
Age 40+
Refusal from breastfeeding
Long use of hormonal contraception (more than ten years)
Mutations in the BRCA1 and BRCA2 genes

The Betty Ford effect

In 1973, the First Lady of the United States Betty Ford announced to the world that she had been diagnosed with breast cancer and that one of her breasts needed to be removed for treatment. The public statement about this disease prompted millions of women to undergo screening. As a result, the rate of detection of cancer in the early stages in the United States has increased dramatically. Researchers called it the “Betty Ford effect”.

Do not wait for cases in friends and relatives – get tested!

Mammography

Over 50 years, thanks to mammography, breast cancer mortality among women in high-income countries where screening coverage exceeds 70% has decreased by 20% to 30% (IARC, 2008).

In 2020, the UK Age randomized controlled trial was completed. Annual mammography in women aged 40 years led to a reduced risk of death from breast cancer in the first 10 years of follow-up.

In the screening group, there was a significant reduction in mortality from breast cancer after 10 years of follow-up. Thus, 83 cases of death were recorded in this group, compared to 219 cases in the observation group.

The survey of 210 thousand medical records of Swedish women aged 20 to 70 years compared breast cancer mortality rates before and after the start of the mass mammography screening of the female population in Sweden. It showed: regular visits to the radiologist reduce the risk of death from this oncology by about 30%.

What else can reduce mortality from breast cancer

According to the National Cancer Institute in the United States, which summarized the results of eight large international studies, routine screening at intervals of 1–2 years, including mammography and clinical examination, can reduce breast cancer mortality by 1/3 in people 50 years and older and has no effect on reducing mortality in women younger than 50 years.

The American College of Obstetrics and Gynecology (ACOG) recommends starting mammography at age 40 and preferably no later than 50. The examination is performed once a year or once every 2 years. This decision is made by the woman together with the gynecologist, depending on the number of risk factors or background diseases. Women should continue to undergo mammography until the age of 75.

If there are genetic predisposition or women have a high risk of breast cancer, mammography should be started from an earlier age – up to 35 years.

What day of the cycle is right for mammography?

6th-12th day of the menstrual cycle, or after the menstrual discharge stops. During menopause and later – the time of diagnosis does not affect its results.

Ultrasound examination

Ultrasound is recommended at the age of 18 to 40 years once a year on the 5th-12th day of the cycle. Or after the cessation of menstrual discharge (in case of short or irregular menstrual cycle).

Ultrasound is not a screening method, although it plays an increasingly important role in the diagnostic of breast cancer. Ultrasound is useful for palpable lesions that are hidden on mammography. Plus, clinically suspicious breast lesions in women younger than 30 years of age, as well as in the evaluation of many abnormalities seen on mammograms.

The FDA has approved the use of automated breast ultrasound in addition to mammography in asymptomatic women with dense breasts, but there is insufficient data on the effectiveness of ultrasound in screening.

Ultrasound can distinguish between fluid-filled cysts (which are most likely not cancer) and solid masses (which may require further testing to make sure they are not cancer). Also, if dense lumps are found, an ultrasound-guided biopsy is performed.

Breast self-examination

Since 2009, the U.S. Preventive Services Task Force guidelines have recommended against teaching breast self-examination. This was based on the lack of evidence regarding the benefits and because of the potential harm from false-positive results.

Despite this, the data on the frequency of self-detection of breast cancer provide a strong basis for breast self-examination. Approximately 50% of breast cancer cases in women 50 years and older and 71% of breast cancer cases in women younger than 50 years are detected by women themselves.

Every woman should be able to conduct self-examination for early diagnosis. Self-examination is recommended on the 6-12th day of the menstrual cycle.

You should be alerted with:

Swelling
Compaction
Local fever
Puffiness
Hard knot
Deepening or wrinkling of the skin
Sores or rashes on the nipples
Redness or darkening of the skin
Itching
Sudden unusual discharge from the nipples
Constant pain in one area
Drooping of the nipple or other part of the breast

REMEMBER, TIMELY DIAGNOSIS CAN SAVE YOUR LIFE!

I tell about your health, the stages of development of the female body and modern methods of prevention and treatment in my courses: A girl becomes a woman, All about you. What it’s like to be a Woman, All about you 35+.

I’m eager to file all of these courses in English, just send me a request to dr.silinaeducation@gmail.com

You can always choose your doctor at the Lior Medical Center.