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October is Breast Cancer Awareness Month, so this month’s blog is dedicated to The Tata's!
It is incredibly likely that you know at least one person who has been affected by breast cancer. 1 in 8 women in the United States will be diagnosed with breast cancer in her lifetime. It is one of the most common cancers found in American women, second only to skin cancer. There are over 270,000 new cases in 2020 alone.
Now for some good news. Thanks to increased awareness, improved treatments and decreased use of hormone replacement therapy (HRT), 64% of breast cancer is detected in the early stages prior to metastasis. The 5-year survival rate with early detection is 99%. There are currently 3.5 million breast cancer survivors in the US today. Badass!
In short, the key is proper screening and early detection. Let’s chat about risk factors, things we can affect, and how to screen for breast cancer tumors.
RISK FACTORS:
GENDER and AGE: Men CAN have breast cancer, however, women are 100x more likely to be diagnosed. It is more common in caucasian women over the age of 55. Breast cancer is more common in women who menstruated prior to age 12, went through menopause after 55, or those who have never had children.
GENETICS: There is a genetic link to developing breast cancer, and you are more likely to develop breast cancer if an immediate family member was diagnosed (especially if they were diagnosed before age 50). Current research and treatment is aimed at identifying BRCA1 and BRCA 2 gene mutations as these may increase your odds of developing breast cancer. 0.25% of the population carries this gene mutation, and it is 10x more prevalent in people of Ashkenazi Jewish descent.
ENVIRONMENT and LIFESTYLE: Like many diagnoses in healthcare, poor diet and exercise can contribute to disease and increase risk of developing breast cancer. Research has linked increased risk with sedentary lifestyle, an unbalanced diet, obesity, alcohol consumption, radiation to the chest prior to age 30 and hormone replacement therapy.
DENSE BREAST TISSUE: Having dense breast tissue can increase your risk for breast cancer and can also make it harder to detect lumps. It is common to have Fibrocystic breast tissue in the premenopausal period which can make the breasts lumpy or bumpy in the absence of breast cancer. This means it is especially important to perform routine self-breast exams to feel for changes from month to month.
PREVENTION and DETECTION:
SIGNS & SYMPTOMS: What can having breast cancer feel or look like? Nipple tenderness, lumps or thickening near the breast or underarm area, change in skin texture, enlargement of pores in the skin of the breast, breast pain, change in size or shape of the breast, swelling, shrinkage, redness.
MONTHLY SELF-BREAST EXAMS: 40% of diagnosed breast cancers are detected by women performing self-breast exams! It is recommended the perform a breast exam in the shower or lying down with the arm above the head. Palpating with the pointer, middle and ring fingers flat, move up and down, side to side and in circles to inspect for any painful or dense tissue. Also inspect in the mirror for any change in symmetry, size or shape of the breasts.
CLINICAL BREAST EXAM: This is most likely to be conducted at your annual wellness visit by your gynecologist or primary physician. In the findings of any abnormal or painful tissue, they can refer out for ultrasound imaging or a biopsy. Haven’t had a clinical breast exam in the last year? SPEAK UP and REQUEST one!
MAMMOGRAM: Let’s be honest - no woman looks forward to this. Nothing like getting "the girls" smooshed between two cold plates. It is currently recommended that women over 40 get a mammogram every 1 or 2 years.
TREATMENT
If you have been diagnosed with breast cancer, your medical doctor or oncologist will decipher which treatment options are best for you. In certain cases, radiation therapy or a mastectomy (surgical removal of one or both breasts) may be warranted. Both of these interventions create scar tissue and adhesions. A pelvic floor physical therapist can mobilize these tissues to decrease pain and restore mobility after such procedures. In the event that removal of one or more lymph nodes was necessary, your surgeon may also refer you to a practitioner who specializes in lymphatic massage (also known as manual lymph drainage) to help facilitate the recycling of lymph and circulation to that area.
In searching for a lymphatic specialist look for the letters CLT which stand for certified lymphatic therapist. Physical and occupational therapists are the most common CLTs but there are many other medical fields that can be certified including: physical therapy assistants (PTA), certified occupational therapist assistant (COTA), speech pathologist (SLP), medical technologist (MT), registered nurse (RN), medical doctor (MD), doctor of osteopathic medicine (DO), chiropractor (DC), physician assistant (PA), certified athletic trainer (ATC). Not sure where to find a CLT? The Lymphology Association of North America (LANA) has a therapist directory on their website at www.clt-lana.org
Bottom line: perform monthly self breast exams, get to your annual wellness check-ups, and if you feel something, say something! You know yourself and your body best.
Health & Happiness,
Dr. Carly and Dr. Katie
*National Breast Cancer Foundation, 24 Sept. 2019, www.nationalbreastcancer.org/about-breast-cancer/.
*Watkins, Elyse J. DHSc, PA-C, DFAAPA Overview of breast cancer, Journal of the American Academy of Physician Assistants: October 2019 - Volume 32 - Issue 10 - p 13-17 doi: 10.1097/01.JAA.0000580524.95733.3d