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Breast Health: What You Need to know

by and on October 07, 2014 1:45 PM

Education is important to raise awareness about any issue, and breast health is no different.

With October being Breast Cancer Awareness Month, some sort of discussion is at the forefront in the minds of many people.

Knowing the facts about when you should start breast cancer screenings, what new technology is out there, and how to be proactive about breast health is essential to staying healthy and cancer-free.

Beginning breast cancer screenings

It is recommended that women begin receiving mammograms to check for potentially cancerous cells when they are 40. However, if a first-degree relative — mom, dad, sister or brother — has had breast cancer, a woman should begin mammography 10 years before the age that the family member was when diagnosed.

"So, if someone's mom had breast cancer at age 45, then her daughter should start mammography at 35," says Eileen Maney, a certified physician assistant with Geisinger Health System. Breast health exams can be done by a patient's primary care doctor, gynecologist or in a breast health center.

Patients will also ask when they should stop getting breast exams, which is a personal decision, says Dr. Anna Hood, a radiologist at the Mount Nittany Health Breast Care Center.

"As long as you would do something with the results, like have surgery or get radiation, if we found something, then keep getting mammograms," she says.

During a mammogram, four pictures are taken of the breast, two on each side. During the procedure the breast is put under compression and squeezed very thin.

"That helps us actually view fine detail better and reduces the amount of radiation that your breast is getting," says Hood. "It's painful sometimes, but it's actually better."

"It also helps us to see breast tissue better because normal breast tissue is white, but so is breast cancer," says Dr. Allison Yingling, also a radiologist at the Mount Nittany Health Breast Care Center. "Sometime it's really subtle differences."

Even before receiving professional breast exams, however, it is recommended that women do their own self breast exams. While naked, lay your hand flat and squished on your breast to check for lumps. Women should also regularly look at their breasts in the mirror, too.

"If you ever notice your nipple points inward instead of out, or your skin looks like its falling inward, or other changes, that can be a sign of cancer, too," says Maney. "Be proactive. Most cancers are found on mammograms, but some aren't, and those are the ones found on the self exam."

"Doing a self exam and knowing what your tissue feels like (is important)," Yingling says. "If anything were to pop up, maybe you would feel a change or notice a difference early."

New technology

Geisinger opened a high-risk breast clinic this year to further help patients take a proactive approach to breast health. It is currently only offered in Danville, but the goal, Maney says, is to have it at the Gray's Woods and other Geisinger locations soon.

"Our main focus (with the clinic) is for women who are at increased risk of breast cancer," she says. This includes women who have a strong family history of the disease, had past breast biopsies and have dense breast tissue.

"We can make recommendations as to whether or not they need MRIs, in addition to the mammogram that most women should be getting," Maney says. "Also, we determine if they need something like genetic counseling or chemo-prevention, which is a pill that you can take to help reduce breast cancer."

Geisinger and Mount Nittany will soon be offering a 3-D mammogram, which will be effective for patients with dense breast tissue since it is sensitive and will pick up more than a regular mammogram machine.

"You'll get multiple slices through the breast, like a CT scan," Hood says. "There are some studies out showing that it will reduce the callbacks ... and may find more cancers."

What you might not know

Last year, Pennsylvania passed a law requiring that a woman's breast tissue density be printed on a patient's mammogram report, according to Hood and Yingling.

"The reason being is, that the denser you are, the less sensitive the mammogram is," Yingling says. "The wording we use tells you how much fat versus dense tissue (non-fatty tissue) is in your breast."

When telling women about their breast density, Hood said many patients have been asking, "What do I do?"

"It's more to just inform more women that mammograms aren't a perfect test and it might not be as good in you because you have dense breasts," she says. Normal lumps in a woman's breast can also be entirely made up of fat tissue, Yingling says, which is why a mammogram is preferred for calculating this over a self-exam.

Recent media attention to actress Angelina Jolie's decision to have a bilateral mastectomy has also been causing some uproar in the breast health world.

In an article published by the New York Times in 2013, Jolie said that she had a preventative bilateral mastectomy, explaining that her mother died when she was 56 after battling cancer for almost a decade.

Through a blood test, which came back positive for the BRCA1 gene, Jolie found out she was at a much higher risk of getting breast and ovarian cancer. The preventative bilateral mastectomy, she said, significantly reduced her chances of developing cancer.

"A lot of patients with breast cancer think they have to have a mastectomy, when really that's not recommended and there's really no extra benefit to getting it done," Maney says.

What people need to realize, she says, is that having either of the BRCA genes is uncommon.

"It is in people who have a strong family history of breast cancer or any family history of ovarian cancer," Maney says. Even if a preventative mastectomy is performed, however, there is still a chance that cancer will pop up and the patient will need other treatments.

"There's always a tiny little bit of cells there," Yingling says. "(But) it definitely drastically decreases their risk."

If someone does have the BRCA gene but doesn't want to get a mastectomy, she can get yearly MRI breast scans, which Yingling says is very sensitive for detecting cancer.

Breast cancer prevention

Preventative care is just as important as breast health exams, Maney says.

"As the population ages, we become more focused on preventative care, and that includes breast health, too," she says. Things that people can do to reduce their risk of getting breast cancer include maintaining a healthy BMI and exercising, limiting alcohol, not smoking and getting plenty of vitamin D.

According to the Mayo Clinic, 600 IUs of vitamin D is recommended daily, which is readily found in most vitamin and mineral supplements and foods like fortified orange juice, eggs, milk, yogurt and fortified cereal.

Annual screenings are also just as important

"Getting yearly mammograms is not preventing you from getting breast cancer," Hood says, "but it can help us find it as early as possible to try to minimize the risk."

This story was produced by the staff at the Centre County Gazette. It was re-published with permission. The Centre County Gazette is a weekly publication, available at many locations around Centre County every Thursday morning.

Brittany is the staff writer for The Centre County Gazette.
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