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Breast Cancer

I remember the exact moment when I got the call. My best friend and cousin (we share the same birthday) called to let me know she was diagnosed with breast cancer. She had undergone a breast reduction in the past and thought the lump she found was just a scar; unfortunately, it was breast cancer.  She was only 42 with a husband and 3 young sons. The plan was chemotherapy followed by surgery, after surgery, there was no sign of disease; she did great! About a year later I received a call from her mother, the cancer was back. I went to her bedside at Mayo Clinic, she was mad. We prayed together, but I had to walk out the door. She passed away before her 44th birthday, leaving behind her amazing husband and three boys aged 6, 8 and 10. We celebrated 43 birthdays together and I just wish for one more.

There are so many stories out there. Friend, mother, wife, daughter, cousin…we all know someone who has been affected. Breast cancer is the second-most common cancer after skin cancer for women. It can affect men but infrequently. According to the Centers for Disease Control and Prevention (CDC), approximately 240,000 women are diagnosed with cancer every year and approximately 2,100 men. Fortunately, with early detection screening, treatment options and a better understanding of the disease, the death rate has declined. 

Early detection screening includes among others self-breast exams, mammograms, ultrasounds and MRIs. Mammograms were officially recommended by the American Cancer Society in 1976. Typically, breast cancer presents with a mass or lump that may or may not be felt by you, changes in skin texture, rash or dimpling of the skin. Therefore, it is important to see your doctor and get a physical with a breast exam every year. Self-breast exams help you notice any small changes in your breasts. Talk to your doctor if you notice any changes. 

Here are the current guidelines from the American Cancer Society:

  • Women ages 40 to 44 should have the choice to start annual breast cancer screening with mammograms (x-rays of the breast) if they wish to do so.
  • Women ages 45 to 54 should get mammograms every year.
  • Women 55 and older should switch to mammograms every 2 years or can continue yearly screening.
  • Screening should continue as long as a woman is in good health and is expected to live 10 more years or longer.
  • All women should be familiar with the known benefits, limitations, and potential harms linked to breast cancer screening.

The problem with mammograms is that they can lead to false positives, anxiety and stress related to false positives and unnecessary testing. Ultrasounds and MRIs are used to obtain more information if there is an abnormality or a risk factor. 

According to the CDC, here are some of the risks associated with breast cancer:

  • Increasing age. Most breast cancers are diagnosed after age 50.
  • About 5-10 percent of breast cancers are thought to be from genetic mutations including but not limited to BRCA1 and BRCA2. These mutations can be tested for. 
  • Reproductive history. Starting menstrual periods before age 12 and starting menopause after age 55 expose women to hormones longer, raising their risk of getting breast cancer.
  • Having dense breasts. Dense breasts have more connective tissue than fatty tissue, which can sometimes make it hard to see tumors on a mammogram. Women with dense breasts are more likely to get breast cancer.
  • Personal history of breast cancer or certain non-cancerous breast diseases. Women who have had breast cancer are more likely to get breast cancer a second time. Some non-cancerous breast diseases such as atypical ductal hyperplasia or lobular carcinoma in situ are associated with a higher risk of getting breast cancer.
  • Family history of breast or ovarian cancer. A woman’s risk for breast cancer is higher if she has a mother, sister, or daughter (first-degree relative) or multiple family members on either her mother’s or father’s side of the family who have had breast or ovarian cancer. Having a first-degree male relative with breast cancer also raises a woman’s risk.
  • Previous treatment with radiation therapy. Women who had radiation therapy to the chest or breasts (for instance, treatment of Hodgkin’s lymphoma) before age 30 have a higher risk of getting breast cancer later in life.
  • Exposure to the drug diethylstilbestrol (DES). DES was given to some pregnant women in the United States between 1940 and 1971 to prevent miscarriage. Women who took DES have a higher risk of getting breast cancer. Women whose mothers took DES while pregnant with them also may have a higher risk of getting breast cancer.

What you can do to reduce your risk of breast cancer, according to the CDC:

  • Keep a healthy weight.
  • Be physically active.
  • Choose not to drink alcohol, or drink alcohol in moderation.
  • If you are taking, or have been told to take, hormone replacement therapy or oral contraceptives (birth control pills), ask your doctor about the risks and find out if it is right for you.
  • Breastfeed your children, if possible.
  • If you have a family history of breast cancer or inherited changes in your BRCA1 and BRCA2 genes, talk to your doctor about other ways to lower your risk.
  • Get yearly physicals with a breast exam.
  • Get mammograms.

Most importantly, live a healthy life. Eat well, exercise and spend time with loved ones. Rely on your friends and family when you need them. Don’t be afraid to ask for help. Remember a time when you helped someone else out and how you felt. People want to help and be there for each other. Enjoy the great outdoors and follow up with your physician if you have any concerns or questions. Many women (and men) survive breast cancer and have wonderful, amazing stories to tell as well.

Here’s to many years of bliss on Boca Grande!

About the Author

Dr. Emily Haly (pronounced hail-ee) joined the Clinic full time in November 2022. Board-certified in internal medicine, she received her bachelor’s degree from Southern Methodist University and her medical degree from the Medical University of South Carolina, where she also completed her internship and residency. She brings some two decades of medical experience to the […]

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