October is National Breast Cancer Awareness Month. The American Cancer Society estimates there will be 4,740 new cases of breast cancer in Minnesota in 2019. Douglas Yee with the University of Minnesota answers questions on the symptoms, treatment and screening for breast cancer.
Q: What is breast cancer?
Breast cancer arises from the normal cells that line the ducts of the breast. These cells undergo genomic changes and “learn” how to grow uncontrollably and spread outside of the breast to lymph nodes and other organs in the body. While rare in men, any abnormality in the breast should be brought to the attention of their health care provider.
Q: Which women are more at risk for breast cancer?
Some breast cancer risk factors include a family history and a woman’s reproductive history. Some of these factors have been incorporated into a risk calculator. Certain ethnic groups can have an inherited risk of developing breast and other cancers. Other uncommon risk factors include radiation to the chest for treatment of childhood lymphoma or Hodgkins’ disease. Lifestyle factors that can increase breast cancer risk include lack of physical activity, obesity and alcohol intake. However, the risks associated with these behaviors are small compared to known risk factors for other cancers such as smoking and lung cancer.
Q: What are the symptoms of breast cancer and how is it detected?
Breast cancer is frequently detected by screening tests including mammography and breast magnetic resonance imaging (MRI). Mammographic screening is recommended for women of average risk, although the age at which to start and the frequency (yearly or every other year) is somewhat controversial. MRI imaging is only reserved for those women of the highest risk. Clinical breast exam by a health care provider is also recommended as a way to screen for breast cancer. While breast self exam is not recommended as a screening test, any abnormal lump should be brought to a health care providers attention.
Q: What are the treatment options for breast cancer?
Breast cancer is almost always treated by surgery – lumpectomy or mastectomy. Radiation therapy after lumpectomy may be advised. In my view, the most important part of breast cancer therapy relates to the use of medical (adjuvant) therapy such as hormone therapy or chemotherapy before or after surgery. Since some breast cancers “learn” to spread to other organs very early in their development, adjuvant therapy has been shown to reduce the risk of recurrence and death from breast cancer because it kills any small groups of breast cancer cells that spread to other organs. Over the past 10 years, new genomic tests have helped women with hormone responsive cancers determine if chemotherapy plus hormone therapy or hormone therapy alone is the best adjuvant therapy.