By Melissa Patrick
Kentucky Health News
Because breast cancer often shows up without any symptoms, getting a mammogram is one of the most important things a woman can do to screen for it — a message that’s especially important to get out in October, which is Breast Cancer Awareness Month.
“Screening mammography is the number one thing you can do for your breast health,” said Dr. Richard D. Gibbs, a radiologist at the University of Kentucky‘s Markey Cancer Center, who is part of its breast-cancer team. He later added, “It’s been proven to save lives.”
Gibbs said it’s important to catch breast cancer early because it tends to lead to better prognosis and outcomes. Also, he said catching it early could result in “reduced or less” treatment.
“Our goal would be to catch every cancer before it’s about a half inch in size, or one centimeter in size,” he said. “As it gets larger, you’re more likely to have metastatic disease or where it spreads to the lymph nodes under the arm or throughout the body. . . . You’d rather catch it smaller before it has time to metastasize.”
The American Cancer Society estimates that nearly 4,000 women in Kentucky will be diagnosed with breast cancer this year and that 640 will die from it.
|Dr. Richard D. Gibbs|
Gibbs, who is also a fellow with the American College of Radiology, said the cancer center follows recommendations of the college and The American Society of Breast Surgeons that women with average risk should get an annual screening mammogram starting at age 40 until about 75. Those with higher risk should start screening earlier.
The cancer society’s guidelines for women with average risk are a bit different. They say annual screening between 40 and 44 is optional; that women 45 to 54 should get mammograms every year; that women 55 and older can continue annual mammograms or switch to getting one every other year; and that screening should continue as long as a woman is in good health and expected to live at least 10 more years.
Some of the risk factors for breast cancer include being female (men can get it too), getting older, being obese, using alcohol heavily, having a family history of breast cancer, starting menstruation early or going through menopause late, having your first child after 30 or never giving birth, having radiation treatment to the chest or breast before 30, and having dense breast tissue.
Gibbs encouraged women with dense breast tissue to seek out tomosynthesis or 3D mammography, which creates a three-dimensional picture of the breast and allows a health-care provider to see beyond the areas of density. In Kentucky, doctors are required to notify their patients if their mammograms show dense breast tissue and that while this tissue is not abnormal, it slightly increases the risk for developing breast cancer.
He also cautioned that while family history increases a person’s risk of getting breast cancer, 70% of women who get it do not have a family history, making it important for every woman who qualifies to be screened.
Gibbs addressed some concerns women have about getting a mammogram. Cost, he said, should not be a concern because federal law requires health insurers to cover mammograms with no cost-sharing. In addition, the Centers for Disease Control and Prevention‘s National Breast and Cervical Cancer Early Detection Program offers free and low-cost mammograms to women who are uninsured or underinsured. Click here to see if you qualify.
Gibbs also stressed that mammograms use a very low dose of radiation, and that while some say it is uncomfortable, it does not hurt. He added that while some women are called back for further evaluation, most of them “do not end up with a biopsy and do not have cancer.” (Screening mammography is not recommended for men, who have about one in 100 breast cancers.)
Signs of breast cancer include any change in the size or the shape of the breast; pain in any area of the breast; nipple discharge other than breast milk, including blood; and a new lump or swelling in the breast or underarm, says the CDC. Men with breast cancer may notice redness or flaky skin in the breast, irritation or dimpling of breast skin, pulling in of the nipple, or pain in the nipple area.
A new way to detect breast cancer early is through a simple blood test called Galleri, which is designed to detect cancers by looking for signals of cancer on DNA that all cells shed into the bloodstream. Once cancer is detected, the test can then determine what part of the body it is most likely coming from.
|Dr. Whitney Jones|
Dr. Whitney Jones, senior medical director of Grail, the manufacturer of Galleri, said the company is working on getting Food and Drug Administration approval for the test. “It’s going to take us a little time,” he said.
He said the test has also not been approved by most insurance companies, but is available in all 50 states with a prescription from a provider.
He encouraged anyone who would like to take the test to ask their physician if they offer it, and if they don’t, to request it online from a telemedicine provider on galleri.com. The Galleri website says the list price for the test is $949.
Jones stressed that the Galleri test is not a replacement for annual screening mammograms, but is meant to supplement it.
“This test is not a replacement for knowing your family history, doing self breast exams or for mammography as recommended by your provider,” he said. “We really intend to backfill and help identify cancers in people either who had their cancer missed through screenings or for people who are not participating in current breast cancer screening right now. There’s also a role for folks who’ve had breast cancer in the past and are more than three years out from successful treatment, we do pick up recurrence of disease as well.”