Breast Cancer Information Sheet: Questions about Breast Health


Q: What are the basic breast health steps?

A: The Susan G. Komen Breast Cancer Foundation recommends the following screening guidelines: Monthly breast self-examination beginning by age 20 Clinical breast examinations at least every 3 years beginning at age 20 and annually after age 40 Annual screening mammography beginning at age 40. Women under age 40 with a family history of breast cancer and other concerns about their personal risk should consult a trained medical professional about risk assessment and when to begin screening mammography

Q: When should I do a breast self-examination (BSE)?

A: The best time to do a BSE is the same time each month; for menstruating women, it should be performed after the menstrual period has ended when the breasts are less tender. For post-menopausal women, it should be performed the same time each month.

Q: What is a clinical breast exam (CBE)?

A: A clinical breast exam is performed by a trained medical professional. It includes visual examination and palpation (feeling) of the entire breast and underarm area, and is performed in both sitting and lying down positions. It is important for women to have both a clinical breast examination and mammogram each year.

Q: How often should I get a CBE?

A: You should get a CBE by a medical professional at least every three years beginning at age 20 and yearly after age 40.

Q: What is a screening mammogram?

A: A mammogram is an x-ray of the breast. This is the best screening tool widely available to detect breast cancer at its earliest, most treatable stages. A screening mammogram is for women who do not currently have any breast problems. The radiologist looks at the film for any abnormality that may indicate an early sign of breast cancer.

Q: How often should I get a mammogram?

A: Starting at the age of 40, women should have annual screening mammograms. Women under age 40 with a family history of breast cancer and other concerns about their personal risk should consult a trained medical professional about risk assessment and when to begin screening mammography.

Common Questions about mammograms

Q: Where can I get a free or low-cost mammogram?

A: Contact your local Komen Affiliate, Health Department, Breast and Cervical Cancer Control Prevention (BCCCP) Program, YWCA's Encore Plus Program and the American Cancer Society.

Q: Does the radiation from a mammogram cause cancer?

A: Today, mammography has little radiation risk. The amount of radiation that is used in mammography has been reduced greatly and is considered to be safe for women of the appropriate age.

Q: How effective are mammograms?

A: Mammography has the ability to detect breast cancers before they can be felt. However, a small percentage of breast cancers cannot be identified by mammography. For this reason, it is important to follow the guidelines for CBE and to practice regular BSE.

Q: What is a diagnostic mammogram? A: A diagnostic mammogram is used to evaluate a woman with a breast problem/symptom or an abnormal finding on a screening mammogram. The diagnostic mammogram will be focused in on the areas where there appeared to be abnormal tissue. It should be performed under the direct, on-site supervision of a board certified radiologist.

Warning signs to heed

If you have any of these symptoms, have your breasts checked by a trained medical professional:

* any new, hard lump or thickening
* change in breast size or shape
* dimpling or puckering of the skin
* swelling, redness, or warmth
* pain in one spot that does not vary with your monthly cycle
* pulling in of the nipple
* nipple discharge that starts suddenly
* an itchy, sore, or scaling area on one nipple

Certain breast problems, such as infections, nipple discharge, or itchy nipples, usually are not cancerous but can look just like symptoms of some rare types of breast cancer.

No matter what the diagnosis, if you feel sure that something is wrong, ask for a biopsy or get a second opinion. After all, no one knows your body better than you.

Questions about risk factors

Q: Who is at risk for breast cancer?

A: All women are at risk for breast cancer. The two most significant risk factors are being female and getting older. The majority of women diagnosed with breast cancer have no other known risk factors.

Q: What are the risk factors that put a woman at higher risk for breast cancer?

A: A personal history of breast or ovarian cancer, a relative who had breast cancer before menopause or in both breasts, a personal history of breast biopsy showing atypical hyperplasia or carcinoma in situ, being young at the time of your first period, starting menopause later, never being pregnant or having your first child after age 30 and having the mutated breast cancer gene BRCA1 or BRCA2.

Q: What role does diet and nutrition play in reducing one's breast cancer risk?

A: For overall wellness and possibly to decrease risk for developing breast cancer, it is recommended that women consume a well-balanced diet rich in fruits and vegetables.

Q: What role does exercise play in reducing one's breast cancer risk?

A: Physical activity may protect you from breast cancer if you are premenopausal or are a younger postmenopausal woman. Exercise reduces estrogen levels, fights obesity, lowers insulin levels and boosts the immune system.

Q: Will drinking alcohol increase one's risk for breast cancer?

A: Numerous studies have shown that high levels of alcohol intake probably increase the risk of breast cancer. In general, the more alcohol you consume, the higher your risk of developing the disease. If you drink alcohol, drink in moderation-less than one drink a day.

Q: Are women who have fibrocystic changes in their breasts at higher risk for breast cancer?

A: Fibrocystic breast changes, lumpiness plus tenderness or pain at certain times of the month, do not increase your chance of getting breast cancer. Keep in mind: Performing breast self-exams will help a woman become familiar with what is normal for her breasts.

Q: What is Hormone Replacement Therapy (HRT) and does it increase my risk for breast cancer?

A: During menopause, a woman's body significantly reduces the production of estrogen. This decrease in estrogen may cause hot flashes, bone loss, vaginal dryness, and mood swings. To lessen the side effects, doctors may prescribe HRT.

A woman's risk of developing breast cancer is increased by about 40 percent if she currently uses postmenopausal hormones (HRT). This increased risk declines over time once a woman stops taking hormones. Overall, there is little, if any, increase in a woman's risk of breast cancer if she is a short term user (less than 5 years).

Q: Are women who use birth control pills at an increased risk for breast cancer?

A: Studies have shown that taking birth control pills for five years or longer can slightly increase your risk for breast cancer. However, there is no apparent increase in a woman's risk of breast cancer ten or more years after she has stopped using oral contraceptives.

Q: Is obesity a risk factor for breast cancer?

A: The effect of adult weight on the risk of breast cancer is different among pre and post-menopausal women. Before menopause, it appears that being somewhat overweight decreases a woman's risk of getting breast cancer. After menopause, being overweight increases the risk of the disease.

Q: What should I do if I am at higher risk for breast cancer?

A: Talk to your doctor about risk assessment and possible options to reduce your risk of breast cancer such as the antiestrogen drug, tamoxifen.

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