Early detection key to breast cancer survival
Without a pill to prevent breast cancer, the key to surviving the deadly disease that is expected to claim more than 40,000 lives in the United States this year lies in early detection, according to a local oncologist. Dr. Andrew Zahalsky, medical director of medical oncology at Mon Valley Hospital, called breast cancer a “serious problem and one of the top cancer incidents and killers in the country.” The average woman has a one in seven lifetime risk of developing the disease.
Zahalsky said the National Cancer Society estimates that that there will be 217,440 new cases of breast cancer diagnosed in 2004 in the United States. Of that figure, the vast majority – 215,990 -are women, but 1,450 men will also be diagnosed. Estimates are that there will be 40,580 breast cancer deaths, including 40,110 women and 470 men.
“The bad news is the number of deaths, but the good news is there is a large discrepancy between the number of cases and the number of deaths,” Zahalsky said.
He added that the good news is that catching the cancer early can help in surviving the disease.
“The bad news is that there is still room to improve,” Zahalsky said.
Zahalsky, who will speak later this month about breast cancer awareness in honor of Breast Cancer Awareness Month, said a lot of the cases can be caught early but the key is a monthly exam.
Although most women visit their gynecologists once a year, a woman could develop cancer a week or month after her yearly exam and not know it until the following year. That’s where the importance of monthly exams comes in.
Zahalsky said conducting a self-examination too often could not be helpful because a woman may not notice a gradual change. Since every woman’s breasts are different, Zahalsky said it is important for women to get a sense of what is normal for their breasts. He said a common recommendation is for women to do a self-exam every month on the last day of their menstrual cycle because of the fluctuation of hormones throughout the month.
Annual mammograms are recommended for women age 40 and over because younger women have denser breast tissue and have a greater chance of false positives.
Although the risk for the average woman is one in seven, for women with BRCA1 or BRCA2 genetic mutations, there is an 85 percent chance of developing the disease by the age of 70. Women with the genetic mutations generally have a family history of the disease.
Unfortunately, those women also have a higher chance of developing ovarian cancer.
When a woman is diagnosed, the cancer is “staged” to determine how large it is and whether or not it has spread to the lymph nodes under the arm. Zahalsky said if the disease is caught early and localized to the breast, there is a “good chance it can be halted.” Conversely, once the cancer travels from the lymph nodes and into the bloodstream, it is “very difficult to completely eradicate it,” Zahalsky said.
“Once it gets to distant parts, it’s virtually impossible to get rid of completely,” Zahalsky said. “It’s better to catch it early. The main thing for prevention is early detection.”
Although prevention is still an active area of investigation, Zahalsky said that some studies have shown that high fat diets can increase the risk of breast cancer. “Eating healthy and exercising is good for heart, vascular and cancer health,” he said. “There is no pill to prevent it.”
Zahalsky said one of the current theories in the development of breast cancer is that because during every menstrual period hormones fluctuate, the more times the breasts go through cycles, the greater likelihood the cells will go bad.
He said the biggest risk of acquiring the disease is being female, and women can decrease their risk by having children because during pregnancy there is a constant level of hormones. He said breastfeeding also decreases the number of cycles, and theoretically the risk.
Zahalsky said starting menses at a later age and menopause earlier could help reduce the chances, but those are things over which women have no control.
While tumors in older women can behave more slowly, that isn’t always the case. Zahalsky said a common myth is if you are 75 years old and are diagnosed with breast cancer, it will progress too slowly to kill you. He said it also isn’t always true that cancer progresses quickly in young women. Some women can have it for six months and be OK, he said.
No matter what, Zahalsky said, conducting a monthly self-exam and reporting any changes to the doctor is the best way to not become a statistic. Zahalsky will speak at noon on Thursday, Oct. 21, at the Monongahela Valley Hospital.