October is Breast Cancer Awareness Month, a perfect time for physicians to talk to patients about screening and prevention of breast cancer.
Every year, more than 200,000 women get breast cancer, and more than 40,000 women die from the disease, according to the Centers for Disease Control and Prevention. Although uncommon, about 2,000 men also get breast cancer, and about 400 men die from the disease. While most breast cancers are found in women who are 50 years old or older, young women are also affected. About 11 percent of all new cases of breast cancer in the United States are found in women younger than 45 years of age.
It is important that patients are aware of the symptoms of breast cancer, understand measures that can be taken to lower their risk and undergo necessary screenings, such as self-breast exams and mammograms.
New technologies have made it possible for large numbers of women to find out whether they carry genetic mutations that increase their risk of breast cancer — a development welcomed by many experts in the field. Some of the mutations detected in those panels are relatively rare and scientists do not yet know how much additional risk they carry. A patient who has learned that they have one of those mutations can cause the unintended consequence of concern and anxiety with little information on making an informed decision on the next course of action.
However, knowing the likelihood that someone who carries a certain mutation will actually develop breast cancer can help the physician and patient decide whether it is appropriate to take certain risk-reduction steps. These steps may include:
- More intensive screening, such as an annual MRI in addition to mammography
- Chemoprevention, including taking a drug that blocks the effect of estrogen on the breasts
- Prophylactic surgery, such as removal of the fallopian tubes and ovaries
- Mastectomy
