Many young women are concerned with breast health and risk factors that may lead to the development of breast cancer. These concerns are understandable, as approximately 1 in 8 women will develop breast cancer in her lifetime. However, there are many important things young women should know when it comes to breast cancer, the risks, and the importance of screenings. We sat down with our breast surgeon Dr. Craig Nemechek and discussed some of the concerns for women when it comes to breast health, and we intend on sharing that information in this blog below!
First of all, women who are fairly young should not be too worried about developing breast cancer. Yes, it is possible and yes there are some rare occurrences of cancer in young women, but the majority of cases are not that way. The majority of breast cancers are found in women over the age of 50. Because of this, women are not encouraged to have a mammogram until they are 40. It appears as though women are taking the recommendation seriously, because appropriate screenings are taking place and cancers are being caught very early on, thankfully.
What happens during a mammogram?
When you get a mammogram the doctors are looking for three things: a lump or mass, a micro calcification (calcium deposits in breast tissue), or architectural distortions (abnormal arrangement of tissue). The last item listed can be many different things such as a scar or a mass. So, if the doctor tells you that you have an abnormal mammogram, don’t jump to conclusions! “Many women have subtle abnormalities, and a lot of times that just means it requires additional views to see if it is a true abnormality or if it disappears,” Dr. Nemechek explains. He goes on in explaining the process, “If it is a true abnormality, then I will recommend a biopsy with an ultrasound or a stereotactic biopsy and even at that point most women, over 90%, will have a benign pathology requiring no surgery whatsoever.”
Breast surgeries usually don’t happen until further down the road. A woman will go through all the same steps listed above and all of the testing first. Then, a surgery would be necessary to remove a lump that cannot be biopsied, or to remove a precancerous or cancerous area. This is still a very small number of women. “Very rarely we will find breast cancers that are advanced, which presents as a pop-able lesion, an area where the nipple is retracted, or some overlying skin change, but again that is very rare this day and age with appropriate screening,” Dr. Nemechek informed us. However, if you do notice a lump, mass, skin change, pop-able lesion, or a change in a nipple, please consult your doctor.
It is possible to develop breast cancer at a younger age, but that is rare and is typically due to a genetic predisposition involving mutations in the BRCA1 and BRCA2 genes. Due to this, it is important to know your family history. “It’s important to know your family history, specifically your mom, sisters, grandmas and aunts because a lot of that factors into their risk when they go into their screening mammogram,” Dr. Nemechek tells us in regard to younger women. Histories of breast cancer AND ovarian cancer are red flags because they are very closely associated genetic syndromes. If you do have some family history of these cancers, there are some wonderful genetic services that are offered to help analyze your risk in developing a cancer and help you decide what measures are best for you based on them (we offer this service at CNOS Sioux Point Clinic!).
Based on information from your family history, screening guidelines can be different for everyone. Although the recommended age to begin yearly mammograms is 40, if you have a genetic predisposition you may need to be screened earlier. Also depending on history, you may require a different type of screening, such as having a mammogram versus having an MRI or even an ultrasound. So, it is extremely important to follow screening guidelines and be aware of your family history. Dr. Nemechek adds, “With or without family history it is very important to follow screening guidelines and also never to ignore a breast complaint.” So if you feel a lump or a mass, if you have a skin change, or something looks odd or new with the nipple, always consult your family doctor. Dr. Nemechek also tells us, “Never assume a change is benign or nothing, although it probably is, it needs worked up appropriately by a doctor no matter the woman’s age.”
As for risk factors you can control, there really aren’t any. There is the myth that certain deodorants can seep into your skin and infect your lymph nodes, but this is not a true risk factor. Sadly, the risk factors for breast cancer are being female, having family history of breast cancer, and getting older. One thing you can do to try and fight this cancer is to maintain a healthy weight, Dr. Nemechek says. “The only identifiable risk factor both for developing breast cancer or the recurrence of breast cancer is to maintain a healthy weight because that factors into estrogen exposure,” which then can increase breast cancer risk.
Of course being aware of your breast health is important, but we understand it can be scary. If this blog did anything, we hope it was to remind you that not all abnormalities are troublesome but you should take appropriate steps when you notice something out of the ordinary. Know your body, do self breast exams, and pay attention to any changes. Young women, remember: if you are menstruating you can experience cyclic changes in your breasts, for example cysts can get larger and smaller during your cycle. However, if you notice a lump or notice changes that have persisted longer than a menstrual cycle, you should have it evaluated. Be aware of your family history, and do your best to keep your body as healthy as possible. And lastly, follow appropriate screening guidelines and you’ll be more likely to stop a cancer in its tracks. Don’t be afraid to talk to your doctor about risks, worrisome areas, and screening guidelines!
At CNOS, our Coordinated Breast Care team believes collaborative care is the most compassionate care, which is why we offer a comprehensive, team-based approach to your treatment. Your interdisciplinary medical team – your general surgeon, oncologist, and plastic surgeon – works together to coordinate the best care for you. To learn more about your breast cancer treatment options, call our Breast Care Coordinator at 605-217-5570.