A Perspective From A Female Plastic Surgeon
Parenting on the Peninsula - October 2010
It happens all too often that I meet a woman in my office who has just received the devastating news that she has breast cancer. As her plastic surgeon, I review the diagnosis and discuss her reconstructive options. As a woman, I can’t help but put myself in her shoes. What would life look like with breast cancer? What would my body look like with breast cancer?
October is National Breast Cancer Awareness Month. It is a reminder that no matter how frightening the idea of cancer is, we need to stop for a moment and think about our breast health. We must empower ourselves with knowledge about this disease and learn the facts that could save our breasts and our lives.
Breast cancer is second only to skin cancer as the most common cancer among women. In 2010, an estimated 200,000 women will be newly diagnosed with breast cancer. A woman has a 1 in 8 chance of developing breast cancer over the course of her lifetime.
It is a diverse disease, meaning that the cancer can vary among individuals, among age groups, and even among the types of cancer cells themselves. And although a diagnosis of breast cancer is overwhelming and frightening, it does not necessarily mean the situation is hopeless. Breast cancer can be successfully treated. In fact, there are an estimated 2.5 million breast cancer survivors currently living in the United States.
Risk Factors
One way to empower ourselves is to understand what factors put us at risk of developing this disease. While cancer occurs due to a combination of factors, many of which are unknown, significant research over the pastseveral decades has identified particular factors that both increase and decrease the risk of breast cancer.
Factors that Increase Risk of Breast Cancer
- Being a woman
- Growing older—the older a woman is, the greater her chance of developing breast cancer
- Genetic mutations in the BRCA-1 or BRCA-2 genes
- Family history of breast cancer
- Personal history of breast cancer or ovarian cancer
- Lobular carcinoma-in-situ (LCIS)
- Dense breasts as seen by mammography
- Hyperplasia from previous breast biopsy
- History of significant exposure to radiation, such as treatment for Hodgkins disease
- Age of menopause after 55
- Never having had children
- Onset of first period earlier than age 12
- Having first child after age 35
- History or current use of birth control pills
- Post-menopausal use of hormone replacement therapy
- Weight gain after menopause
There are also certain factors that may lower the risk of breast cancer. There is growing evidence that maintaining a healthy weight after menopause reduces the risk of breast cancer. Limiting alcohol intake also appears to decrease the risk of breast cancer. Overall, maintaining a healthy lifestyle is something within our power that contributes to breast health.
Know What is Abnormal
In many instances, breast cancer is asymptomatic. However, knowing what is normal for your breasts is an important way to stay on top of your breast health. By performing regular self-exams, you will know what your breasts normally look and feel like. If a change occurs, you should discuss it with your health care provider. The following are abnormal findings that should be reported right away:
Abnormal Breast Findings
- New pain that persists
- Lumps, knots, or thickening in any part of the breast or armpit
- Redness, swelling, or darkening of breast skin
- Change in size or shape of breast
- Puckering or pulling of skin
- Dimpling or changes in nipple
- Itchy or scaly rash over nipple
- New nipple discharge
Early Detection
Another way to empower ourselves is to understand that if breast cancer is detected early, there are more treatment options and better chances for survival. Early detection of breast cancer can be increased by both clinical breast exams as well as screening mammograms. As screening programs have become more common, more cases of breast cancer have been detected earlier, leading to better outcomes. While guidelines for screening tests may vary depending on your particular situation, a general guide is as follows:
Guidelines for Screening Tests
Age 20–39
- Clinical breast exam at least every 3 years
- Women with risk factors may need more frequent and/or additional screening as recommended
Age 40 and over
- Clinical breast exam once per year
- Mammogram: once per year
There is still much that is unknown about breast cancer, why some women get it and others do not. Some factors that put us at risk cannot be altered, such as age, positive family history, and our genetic makeup. But there are things that we can do to educate ourselves about breast cancer. Understanding what puts us at risk, knowing what is normal for our breasts, and advocating early detection promotes better breast health for all women. October is National Breast Cancer Awareness Month, but education about breast health may help save our lives all year, every year.
Source: American Cancer Society. Cancer Facts and Figures 2010. Atlanta, GA: American Cancer Society, 2010
Dr. Jennifer Weintraub is a Stanford-trained plastic and reconstructive surgeon with a special interest in women’s health and breast cancer reconstruction. Her practice, Duet Plastic Surgery, is located in Palo Alto.