Early Detection is Your Best Prevention

One color seems to pop up everywhere this time of year.  Pink.  It is virtually impossible to go into any store without seeing a display decked out in 50 shades of pink.  With so much pink around, it is easy to acclimate to the color and forget what all that pink represents in the first place.  Pink is not just cute; it is not just fashionable, or girly.  It is a symbol for breast cancer – a disease that 1 in 8 women will be diagnosed with in their lifetime.  It represents the more than 14,730 women who will be diagnosed with the disease this year in the state of New York and the more than 226,870 women who are diagnosed nationwide each year. 

It is important for women to know their bodies and their cancer risks, as cancer is most treatable when detected at its earliest, most treatable stage.  Let me tell you about Tracy Harnly, a young, otherwise healthy (she ran marathons), mother of two adorable boys.  She is one of the most energetic, positive individuals I’ve ever had the privilege of knowing.  She noticed a change in her breast, but didn't go to the doctor right away thinking that she was young, healthy and had no prior family history of breast cancer.  Not to mention, she was a busy raising two young sons.  As it turned out, that decision forever altered her life when she was diagnosed at age 30 with Stage 4 breast cancer. 

Tracy fought her cancer diagnosis with everything she had and in the process, she inspired everyone around her.  What made Tracy remarkable was that she never let the cancer defeat her.  With a smile on her face, she made it her mission to do whatever she could to raise funds, to educate women about prevention and early detection, to support those facing a diagnosis and to rally everyone and anyone she met to fight back against a disease that impacts us all.  I will never forget her speaking to a gymnasium full of college students, who I know, inspired by her humor, her story, and her message will pay attention to their body and get the screening they need.  Sadly, this hero lost her battle to breast cancer at the age of 36.  But she managed to educate hundreds, if not thousands, on her cancer journey.  Thanks to Tracy, I know there are women whose lives will be saved because they heard her story and made sure to not put off their annual exam.  This October, when you see pink, let it be a reminder to tell the women your life to put themselves first and to get the screenings they need.

The American Cancer Society issues the following recommendations in regards to breast cancer screening and early detection:

Women age 40 and older should have a mammogram every year and should continue to do so for as long as they are in good health.  Current evidence has confirmed that mammograms offer substantial benefit for women in their 40s. However, mammograms also have limitations, so it is important for women to discuss the benefits and limitations of yearly mammograms.

Women in their 20s and 30s should have a clinical breast exam (CBE) as part of a periodic (regular) health exam by a health professional preferably every 3 years. Starting at age 40, women should have a CBE by a health professional every year.  The clinical breast exam offers a chance for women and their doctor or nurse to discuss changes in their breasts, early detection testing, and factors in the woman's history that might make her more likely to have breast cancer. The exam should include instruction for the purpose of getting more familiar with your own breasts.

Breast self-examination (BSE) is an option for women starting in their 20s. Doing a BSE regularly is one way for women to know how their breasts normally look and feel and to notice any changes. Women who choose to use a step-by-step approach to BSE should have their BSE technique reviewed during their physical exam by a health professional. If a change occurs, such as development of a lump or swelling, skin irritation or dimpling, nipple pain or retraction, redness, or scaliness of the nipple or breast skin, or a discharge other than breast milk, you should see your health care professional as soon as possible for evaluation.

Women at high risk (greater than 20% lifetime risk) should get an MRI and a mammogram every year. Women at moderately increased risk should talk with their doctors about the benefits and limitations of adding MRI screening to their yearly mammogram.

Women at high risk include those who:

• Have a known BRCA1 or BRCA2 gene mutation
• Have a first-degree relative with a BRCA1 or BRCA2 gene mutation, and have not had genetic testing themselves
• Have a lifetime risk of breast cancer of 20% to 25% or greater, according to risk assessment tools that are based mainly on family history
• Had radiation therapy to the chest when they were between the ages of 10 and 30 years
• Have Li-Fraumeni syndrome, Cowden syndrome, or Bannayan-Riley-Ruvalcaba syndrome, or have one of these syndromes in first-degree relatives

Women at moderately increased risk include those who:

• Have a lifetime risk of breast cancer of 15% to 20%, according to risk assessment tools that are based mainly on family history
• Have a personal history of breast cancer, ductal carcinoma in situ (DCIS), lobular carcinoma in situ (LCIS), atypical ductal hyperplasia (ADH), or atypical lobular hyperplasia (ALH)
• Have extremely dense breasts or unevenly dense breasts when viewed by mammograms

The important thing is for women to talk to their doctor about what screenings are appropriate for them based on their risk factors and women should report any breast changes to their health professional right away. 

For more information about breast cancer or screening recommendations, visit www.cancer.org.