Touch yourself. Thoroughly and often.
A self-exam is one of the few ways to find a lump in the breast before the age of 35, when doctors and the Susan G. Komen of Southern Nevada recommend the average patient should get a baseline mammogram.
Despite new technology and advances in medicine, “the No. 1 screening for breast cancer is still the mammogram at the age of 40,” said Dr. Josette Spotts, a breast surgeon with Comprehensive Cancer Centers of Nevada.
“The mammogram can really save your life,” Dr. Mary Ann Allison, an oncologist with CCCN, said. “I can stack people around the block who would never have known they had breast cancer without a mammogram.”
Despite recent studies that show women without a family history of cancer can wait until age 50 to start yearly mammograms, the Komen organization and doctors at CCCN advise patients to start at 40.
“At Susan G. Komen, we are proponents of breast self-awareness. Of course, part of that is doing a self-exam, but the bigger message is that it’s important for us to be aware of our bodies and what is, or is not, normal for us,” said Stephanie Kirby, executive director of Susan G. Komen Southern Nevada. “If something is noticed that has not been present previously, we suggest getting it checked immediately. Six of the eight signs of breast abnormalities are visual, so it is so important to be aware of our own bodies.”
According to the organization, the eight warning signs are lumps, hard knots or thickening; unusual swelling, warmth or redness; change in size or shape of breast; dimpling or puckering of the skin; itchy, scaly sore or rash on nipple; pulling in of the nipple or other part of the breast; sudden nipple discharge; pain in one spot that does not go away.
Spotts said mammograms should begin between ages 35 and 40, but that a patient with a family history of cancer should begin screenings 10 years younger than the age of the family member when they were diagnosed. For example, if a patient’s sister was diagnosed with breast cancer at age 38, the patient should begin screenings at age 28.
Risk factors that increase the chance of breast cancer include family history, age, ethnicity, early menarche, late age at first birth and the use of postmenopausal hormone replacement therapy.
And while breast implants don’t affect risk or testing for breast cancer, patients with dense breast sometimes struggle with testing. Breast density is a measure of breast and connective tissue compared to fat.
“Breast density makes interpretation of mammograms potentially difficult,” Spotts said. “Cancers appear white on a mammogram, as does dense breast tissue.”
Often patients with dense breasts require an MRI or ultrasound in addition to mammograms. Spotts warned that the MRI has a high false-positive rate and said the new 3-D mammograms can help render a clearer picture of a patient’s tissue.
Tomosynthesis is performed much like a standard mammogram but creates a three-dimensional image that can be looked at in slices.
“When you slice through, you can look closer at irregularities,” Spotts said.
Regardless of the type of testing, the one thing all the experts agree on is the need to do it regularly. Mammograms should be performed yearly. Most gynecologists will recommend that patients begin doing annual mammograms timed to their annual checkup and Pap smear in order to keep women on a schedule.
“You will find that people will do what they can to avoid squishing their boob,” Allison said. “But mammograms are the foundation to finding breast cancer. I don’t think there will ever be a substitute. You can’t go without a mammogram. It’s very, very important.”