Are You One in Eight?

Think of eight women in your life... at least one of them is likely to get breast cancer in her lifetime.

Those are terrible odds.

Here at The Sunday Refresh, we've personally known too many women who have fought breast cancer... some who survived and some who lost their lives. So we know just how important this topic is.

That's why today we wanted to touch on some facts you should know about this terrible disease. Educating yourself is the first step toward a healthier future.

How many people will get breast cancer?

About one in eight women will develop invasive breast cancer in her lifetime. In 2018, researchers predict about 266,000 new cases of invasive cancer diagnosed in women and another 64,000 non-invasive cases. Men also get breast cancer. Their lifetime risk is one in 1,000, but that number has increased in the past decades, meaning we could see more cases in the coming years.

What do you mean, invasive and non-invasive?

Non-invasive means the cancer stays in the same place in the breast, either the milk ducts or the lobules. It's sometimes called pre-cancer because it doesn't spread to other tissue. Invasive means just that, the cancer is growing and invading healthy tissue throughout the breast.

Are there different types of breast cancer?

Doctors describe breast cancer by where it is or how it appears. The most common is invasive ductal carcinoma. That's a cancer that starts in the milk duct and then grows outward into the tissue. Some types respond better to treatment than others. For example, inflammatory breast cancer grows rapidly and avoids early detection, meaning it's much harder to treat.

Breast cancer also falls into categories based on the types of receptors found in the tumor. These receptors attract estrogen, progesterone, and the HER2/neu gene. For example, ER (estrogen receptor) positive means the tumor grows from estrogen production. If you are ER or PR (progesterone receptor) positive, hormone therapy after your traditional cancer treatment can prevent recurrence. About 80% of all tumors are ER-positive. If you have triple-negative breast cancer, none of these receptors are present. Unfortunately, that makes it more difficult to treat, though not impossible.

Is all breast cancer genetic?

It might surprise you, but only about 10% of all breast cancers are hereditary. The most common genes responsible are BRCA1 and BRCA2... However, just because you have a mutation on one of these genes doesn't necessarily mean you'll get cancer. There are other genes responsible as well.

Your risk does increase based on family history. Risk factors include having any blood relatives who had breast cancer before 50, relatives with triple-negative breast cancer, Ashkenazi Jewish heritage, or a family history of other cancers.

How do I check for breast cancer?

Start with self-exams every month. Check for things like unusual shapes, swelling, redness, or dimpling. Check for lumps both lying down and standing up. Using light, then medium, then firm pressure, work in small circles to check for any unusual lumps. If you're still menstruating, it's best to do it about a week after the end of your period, to avoid any swelling.

What if I find a lump?

You'll need to report it to your doctor. But don't panic... While you might have breast cancer, there's a chance you have something called fibrocystic breast disease. More than three million women struggle with this each year. In fact, some estimates put the lifetime prevalence at 70% to 90%. With this disease, the breast feels like it has lumps that are actually fluid-filled cysts or fibrous scars. Typically, they enlarge with changes in hormone levels, and may cause pain or tenderness.

What about mammograms?

The American Cancer Society recommends women start mammograms at 45, and get them annually until 54. At that point, it recommends switching to a mammogram every two years, unless you're in a high-risk group. It's also important to remember that mammograms have about an 87% detection rate, making them an important tool to find breast cancer early. However, each test increases the odds of a false positive. After 10 years of exams, you're about 50% to 60% likely to get a false positive. That requires additional testing.

If you're under 40, the false positive rate is higher as well. In addition, many providers may save it as a later measure if you're of child-bearing age, as the radiation can cause some damage.

When it's time for your first mammogram, you may want to take an aspirin for the pain and be sure to go at a time when you aren't close to your period, so your breasts aren't as tender. Also be sure to wear a shirt instead of a dress and avoid any deodorant, powders, or lotions. These may contain metallic traces that give false readings.

What if it is cancer?

Breast cancer, like many other cancers, uses the traditional triad of treatments: surgery, radiation, and chemotherapy. You may only need one of these or you may need a combination. Much of this will depend on the type of cancer and whether or not it is invasive.

Although it is the most commonly diagnosed cancer in women, survival rates improve every year. In 2017, about 41,000 people died from breast cancer. But that's still much lower than it was. Between 1989 and 2015, breast cancer deaths in women dropped 39%, largely due to early detection. That's why we recommend educating yourself about the risks and using regular self-exams to keep in tune with your health.

Here's to a fresh start,

Amanda Cuocci & Laura Bente
February 25, 2018