Vigilant screening leads the fight against breast cancer

The following article was contributed by Dr. Scott Maul. Dr. Maul specializes in oncology and hematology at Aurora Cancer Care in Grafton and Glendale. He can be reached at 262 329-5000 or 414 906-4400.

Recent debates regarding mammography guidelines have generated confusion regarding best practices in cancer screening. Despite this, most women are aware that early detection of breast cancer can save lives through regular mammography screenings and clinical breast exams.

Women should consult with their health care providers to discuss their individual risk factors for breast cancer and to develop a personalized schedule for breast cancer screening.

Those at increased risk (women with a family history, genetic tendency or past breast cancer) may benefit from starting mammography screenings earlier, having additional tests such as a breast ultrasound or MRI, or more frequent exams.

Most national guidelines for the early detection of breast cancer continue to recommend:

• Yearly mammograms starting at age 40 and continuing for as long as a woman remains in good health.

• Clinical breast exams every three years for women in their 20s and 30s and every year for women age 40 and older.

• Women should report any breast changes promptly to their health care provider.

• Monthly breast self-exams are recommended for women, starting in their 20s.

Women are more likely to notice a change in their own breasts by doing monthly exams, versus only having them checked at an annual exam.

Aurora Health Care offers a Breast Cancer Risk Assessment Tool to gauge the likelihood that a woman will develop breast cancer. This is an interactive tool designed by scientists at the National Cancer Institute (NCI) and the National Surgical Adjuvant Breast and Bowel Project (NSABP) to estimate a woman’s risk of developing invasive breast cancer. It is based on a statistical model known as the “Gail Model.”

It was designed by researchers as a tool for health care providers to calculate a woman’s risk of developing breast cancer within the next five years and within her lifetime (up to age 90). It takes into account seven key risk factors for breast cancer.

Age
Age at first period
Age at the time her first child was born (or has not given birth)
Family history of breast cancer (mother, sister or daughter)
Number of past breast biopsies
Number of breast biopsies showing atypical hyperplasia
Race / ethnicity
Although the tool has been used with success for women with strong family histories of breast cancer, more specific methods of estimating risk are appropriate for women known to have breast cancer-producing mutations in the BRCA1 or BRCA2 genes.

Even with its current limitations, this Breast Cancer Risk Assessment Tool (Gail Model) can be useful. However, it is not a perfect predictor of individual risk. The model can estimate a woman’s risk, but it cannot tell definitely whether or not she will get breast cancer during her lifetime.

Hopefully, women have received the life-saving message that early detection of breast cancer saves lives through a three-pronged approach that includes breast self awareness, mammography screening and clinical breast exams.

Some encouraging news for all women is that increased mammography screening and improved treatment options have greatly improved the long-term outlook for thousands of breast cancer survivors.

In the future, new technology and refined assessment tools may hold the promise of even better detection and subsequent treatments, but for now regular mammography screening and vigilance remain at the forefront in the early detection of breast cancer.