October is Breast Cancer Awareness Month, a time to recognize the need for early detection for one of the most common types of cancer in women in the United States.
Bonni Guerin, MD a hematologist/oncologist and director of the Breast Cancer Treatment and Prevention Program at Overlook Medical Center with Atlantic Health System, joins a Community Conversation to discuss the importance of mammograms and breast health.
Why is Breast Cancer Awareness Month important?
Dr. Guerin says every month should be Breast Cancer Awareness Month. Breast cancer is a common, yet preventable disease. It is important to get a mammogram, especially if you are in a high risk group or are over the age of 50. Dr. Guerin notes that only 65% of women are getting their annual mammogram and she hopes that this month will raise awareness and remind women to get screened.
What can women expect when getting a mammogram?
Getting a mammogram can seem overwhelming, but Dr. Guerin says the screening is straightforward. A mammogram is an outpatient procedure that usually takes about two minutes to complete. Your breast is placed on a plate and is compressed while an image is taken. Dr. Guerin explains, “It's a pretty quick test. The techs that generally do the mammograms are good at explaining every step of the way…You'll hold your breath for a few seconds while they snap the button, and you'll have your mammogram.” She adds that when a woman receives her first mammogram, because there’s no baseline results to compare it to, it’s not unusual to be called back for a second look. She attributes this to doctors wanting a thorough and comprehensive screening.
What are doctors looking for in the mammogram results?
Ultimately, doctors are looking for signs of early breast cancer or signals of pre-cancer. For instance, small areas of calcium deposits are a concern and could indicate pre-cancer. Dr. Guerin says mammograms are not only a way to diagnose and find a cancer, but are also an important tool to prevent cancer from ever appearing.
How effective is a mammogram at finding breast cancer?
Mammograms find about 85% of breast cancers. Dr. Guerin notes that some women with denser or more complicated breasts may require ultrasounds and MRIs in addition to a mammogram.
How successful are physicians at treating breast cancer?
Dr. Guerin estimates that over 85% of breast cancers are cured in the United States. The key to that high success rate is early detection.
What is breast density and how does it affect the mammogram?
Dr. Guerin says dense breasts are generally found in younger women with lower body fat. As women age, their breasts become less firm, and the breast tissue becomes darker. This makes it easier to detect cancer and calcium in the breasts, which appears in white on a mammogram. Dense breasts therefore camouflage cancer and make it more of a challenge to detect. Dense breasts are also a risk factor for breast cancer. Often, women with dense breasts receive an ultrasound in addition to a mammogram for an extra layer of detection.
Is there anything a woman can do to decrease their risk of cancer if they have dense breasts?
Although there are medications that can lower breast density, Dr. Guerin would not recommend them. A more conservative approach would be to determine the level of density and utilize additional screenings such as an ultrasound or MRI. In addition, Dr. Guerin suggested focusing on the goal of decreasing breast cancer risk through a low fat diet, maintaining a healthy body weight, getting regular exercise, avoiding alcohol and quitting smoking.
Is family history linked to breast cancer?
Dr. Guerin says family history is a risk factor for breast cancer. Women with siblings or parents who had the disease are at greater risk of developing breast cancer themselves. She also notes that on average, about 1 in 8 women in the United States will develop breast cancer in their lifetime. Women in New Jersey have a higher risk, as do those of Ashkenazi descent.
How helpful is it to develop a relationship with a primary care doctor when thinking about breast cancer?
Dr. Guerin says it is important to develop a relationship with a primary care doctor to make a connection and to have a trusted voice to answer questions and concerns. She notes that her relationship with breast cancer patients is even more intimate, given the nature of the patient’s diagnosis.
If your breasts are itchy, is that a sign for concern?
According to Dr. Guerin, itchy breasts are unlikely to be a sign of breast cancer. Instead, she said that it could be a dermatologic condition, perhaps related to a rash or an insect bite. She suggested checking with a doctor for a diagnosis.
What is background enhancement on a breast MRI?
Background enhancement is a common phrase used to describe women with dense, or as Dr. Guerin calls them, “busy breasts”. She explained, “Often I see that very young women have denser, more active breast tissue. And so if you have a busy breast, there's a lot of background noise. And when I'm trying to (read an MRI)…it becomes more complicated.” A dedicated breast radiologist will often call back a woman with this condition and perform a magnification mammogram or an ultrasound to get a better picture of the breast tissue.
How has breast cancer detection and treatment developed over time?
Dr. Guerin is excited about the advancements in breast cancer detection and treatment. She says the biggest recent change has been the advent of 3D mammograms, which provide a more comprehensive view of the breast for screening and diagnosis. Overall, mammograms have improved the survival of breast cancer by 40%. “So I would say to women, not only get your mammograms, but for every husband, every sister, every son, daughter, mother, father, anybody out there, you need to look to your right and your left and find a woman and ask her, did you have your mammogram?”
Be Proactive About Your Health
To stay safe and healthy, it's good to have a primary care provider who knows and understands your health history and wellness goals.