What Every Woman Should Know About Breast Cancer

October is Breast Cancer Awareness Month; since the announcement of Angelina Jolie to remove both her breasts (double mastectomy) to prevent breast cancer, public awareness of breast cancer has boosted. Jolie found that she was a carrier of the mutated BRCA1 gene that increases the likelihood of developing breast (and ovarian cancer); breast cancer also claimed the life of her mother.

The Risk Factors of Breast Cancer

Every woman should be aware of the risks associated with breast cancer, including learning about their family medical history. The shifting paradigm regarding the causes of breast cancer continues to evolve, attributing to a series of lifestyle factors, genetics, and environmental causes. However, further research is required, particularly exposing the environmental causes, which is heavily underestimated and key in breast cancer prevention.

Alternative Solution for BRCA1 and BRCA2 Carriers

Recently published in EBioMedicine, a study regarding BRCA1 and BRCA2 mutations, found that women with these mutations tend to have very low levels of a molecule called osteoprotegerin (OPG). This molecule blocks a protein (RANKL), which together with progesterone act as a catalyst for breast cancer. This study leans towards drug therapy targeted to reduce the risk of breast cancer by a drug (rather than preventive surgery – double mastectomy) that mimics the effect of OPG or inhibits the effects of progesterone.

Breast Self-Exam

Women need to know what physical changes to look out for regarding breast cancer symptoms, and to examine their breasts regularly. In addition, schedule an appointment with a specialist immediately if you notice or feel anything unusual, such as a lump (including under the arm), dimpled or inflamed skin, or experience breast pain. This also includes changes in the nipples, such as (sudden) inverted nipples, flaking or discharge. Symptoms of inflammatory breast cancer, for example, a rare and aggressive form of breast cancer can be confused with another condition (mastitis), which carries similar symptoms. Mastitis that has not cleared up following antibiotic treatment requires a biopsy.

Early detection is imperative as with other types of cancer as tumors respond better in the initial (early) stages of development, fearing to seek medical attention only allows the progression and spread of tumors beyond (breast) tissue – making it harder to treat and manage effectively. Women are urged to take control of their health and educate themselves about breast cancer; including seeking a second opinion if necessary.

Early Detection in Israel

Israel Cancer Association (ICA) reports that early diagnosis of breast cancer reduces cancer spread and mortalities – there are fewer mortalities in Israel due to a national mammography program created in the 1990s. In addition, women over the age of 40 are highly recommended to have regular mammograms. Israeli patients receive letters and are actively reminded of upcoming mammograms – Even women living in remote areas have the opportunity to have a scan in a mobile unit that is transported in a special trailer. Since the beginning of the program the percentage of cancers detected in the initial stages rose, and the mortality rate from breast cancer, respectively, significantly decreased. Take for example, in 2005, 58% of cases were identified in the initial stages, and 65% in 2012. This data released by the ICA emphasizes the need for early detection that may very well save your life!

Guidelines for Early Detection in Women

• Starting in their 20s – conduct monthly breast self-exams (BSE)
• The 20s to Late 30s – Clinical breast exam (CBE) every 3 years
• 40 and Over – CBE yearly

Treatment of Breast Cancer

Today most women diagnosed with breast cancer undergoing breast-conserving surgery (lumpectomy) rather than a mastectomy. Treatment now combines a collaborative approach with the surgeon and oncologist (and most often a radiation oncologist) this ensures a better understanding of the individual’s case and determines an effective breast cancer treatment plan. Treatment approaches continue to advance, such as the use of high-dose radiation therapy, over a short course for early-stage breast cancer, based on a study published in Jama Oncology.

Breast Cancer Recurrence

Recently published in The New England Journal of Medicine, detailed how a genetic test, Oncotype DX (by Genomic Health, Inc.) is an effective tool in helping to determine which women should forgo chemotherapy following breast cancer surgery. The test focuses on a group of specific genes of an individual patient that influence the behavior and response of cancer to treatment. In addition, the test facilitates oncologists in determining recurrence of early-stage estrogen receptor-positive breast cancer and ductal carcinoma in situ.

In a separate study by the John Hopkins Medical Center, it was revealed that obesity with a family history of breast cancer could lead to cancer returning in cancer patients who were previously treated. The Center reported that implementing interventions to prevent rapid weight gain (following chemotherapy and statins) in younger women could be the step forward.

Breast Cancer Screening at HMC

Along with a clinical breast exam, Herzliya Medical Center uses Hologic 3D Mammography technology, which produces sharp 3D images and with lower radiation doses – this technology minimizes the need to perform an invasive breast biopsy. Most importantly, Hologic technology ensures the early detection of breast cancer – imperative to the treatment’s success. Prior to your mammogram, remember not to use any deodorant or lotions and to schedule it after your period to avoid discomfort. Together we can beat cancer, spread the word!