Thanks to screening, many breast cancers are found at an early, curable stage.
A cancer diagnosis is never easy to hear, but thanks to improvements in both treatment options and screening, many women are catching them earlier—and at a more easily treatable stage.
“It's important to remember that many of the breast cancers that are diagnosed, fortunately, are diagnosed at an early stage,” says Brenda Panzera, MD, oncologist at The Mount Sinai Hospital and Lenox Hill Hospital. “Many, many of them are curable.”
Breast cancer screening is the most common way breast cancer is found, according to Dr. Panzera. A basic breast cancer screening appointment includes the following:
The patient’s medical history and family history
A physical examination of the breasts and the rest of the body
Questions about potential symptoms
Questions about current medications
And, depending on your doctor’s recommendation, a mammogram.
The reason a screening is the most common way cancer is found is because it occurs *before* someone notices symptoms: It’s meant to catch the disease early, since symptoms usually don't appear until the cancer has already progressed. The age that someone begins screening for breast cancer may vary based on their risk factors for breast cancer.
“Women ages 50 to 74 should have screening mammograms, and women over the age of 75 should consider continuing screening mammograms if their life expectancy is greater than 10 years,” says Dr. Panzera. Find out what to expect at your first mammogram here.
Screening Abnormalities: The Next Step
“If an abnormality is noted on a physical examination, typically the next step is imaging. That usually starts with a mammogram, which may or may not then be followed by an ultrasound or an MRI,” says Dr. Panzera. MRIs are usually only used for women who have a high risk for breast cancer, according to the National Cancer Institute (NCI).
Any abnormality is then evaluated by a biopsy, which is when a tiny sample of tissue is removed from the abnormal area to analyze under a microscope by a pathologist.
If test results are positive, more screening can help the oncology team determine the stage of the breast cancer, and the doctor can then help guide the patient through treatment options. Alternatively, the patient can seek a second opinion (since false-positive results are common, according to NCI).
The Role of Breast Self-Exams
Breast self-exams, or the process of checking the look and feel of your own breasts for changes or abnormalities, has often been recommended for women, but the truth is, only a small percentage of breast cancers are found this way.
“Doing breast self-exams does not replace a mammogram. Although it is useful for breast self-awareness, a mammogram is really the screening modality that's recommended,” says Dr. Panzera. “That being said, however, there are many women who are diagnosed with breast cancer who will be the first to notice that something has changed.”
In other words, continue doing breast self-exams, but don’t skip your mammogram just because everything looks “normal” to you.
“Anything that a woman discovers that they feel is different or unusual, or they question, or they're concerned about, should really immediately be brought to the attention of a healthcare provider,” says Dr. Panzera.
Dr. Panzera is a clinical instructor in hematology and oncology at the Mount Sinai School of Medicine, and attending physician at Mount Sinai and Lenox Hill Hospitals.
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It's important to remember that many of the breast cancers
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that are diagnosed fortunately are diagnosed at an early stage.
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Many, many of them are curable,
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and your healthcare providers are here
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to help guide you through the process of doing the next steps,
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getting the diagnosis, having the appropriate treatment,
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and then being followed, so that you can get to the other side
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and live a full life, hopefully without cancer.
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Most commonly, breast cancer is found on screening.
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So women would come to an office, they would see their physician,
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they would have a complete history and physical examination,
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which would involve questions about
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whether or not that person was having symptoms of any type,
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what their past medical history is, what medications they're taking,
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and then the practitioner would perform a physical examination,
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which would be a head-to-toe examination looking for any signs or symptoms
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that could be worrisome for cancer.
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If an abnormality is noted on a physical examination,
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typically the next step is imaging.
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That usually starts with a mammogram,
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which may or may not then be followed by an ultrasound or an MRI.
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That abnormality is usually ultimately evaluated by a biopsy.
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A biopsy is when a practitioner will take either some cells
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or a piece of the tissue where the abnormality is noted.
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That will then be evaluated by a pathologist under the microscope,
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specifically looking for cancer cells.
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Women ages 50 to 74 should have screening mammograms,
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and women over the age of 75 should consider continuing screening mammograms
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if their life expectancy is greater than 10 years.
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Doing breast self-exams does not replace a mammogram.
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Although it is useful for breast self-awareness,
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a mammogram is really the screening modality that's recommended.
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That being said, however, there are many women
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who are diagnosed with breast cancer who will
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be the first to notice that something has changed.
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Anything that a woman discovers that they feel is different or unusual,
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or they question, or they're concerned about,
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should really immediately be brought to the attention of a healthcare provider.
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Breast cancer screening (PDQR) - patient version. Bethesda, MD: National Cancer Institute, 2019. (Accessed on January 16, 2020 at https://www.cancer.gov/types/breast/patient/breast-screening-pdq#_43.)
What is breast cancer screening? Atlanta, GA: Centers for Disease Control and Prevention, 2018. (Accessed on January 16, 2020 at https://www.cdc.gov/cancer/breast/basic_info/screening.htm.)