Breast Cancer Awareness Month:
A Call to Action

Betty Ford. Shirley Temple Black. Linda Ellerbee. According to the American Cancer Society, in 1997 approximately 180,200 women in the United States will join the list of those who have been diagnosed with an invasive form of breast cancer. And they won't all be famous.

She may be a neighbor up the street, a mother of three, an older sister, a co-worker.

In recognition of October as National Breast Cancer Awareness Month, medical professionals are encouraging women to take action through early detection.

"There is no way to prevent breast cancer as far as we know. None of us can change our sex. None of us can turn the aging clock back. None of us can change our genetic makeup," says Dr. Carol B. Stelling, chief of breast imaging at The University of Texas M. D. Anderson Cancer Center. "What we can do is guard our good health by participating in screening programs so that if a cancer is developing, we have the best chance of detecting and diagnosing that cancer while it is still in its early stages."

Mammography - which detects 90 percent of breast cancers - is the best way to detect breast cancer in an early stage before physical symptoms surface. According to guidelines revised in March by the American College of Radiology and the American Cancer Society, women should begin receiving annual mammograms at the age of 40.

"We now have the summary of data from controlled trials that shows women ages 40-49 do benefit from yearly screening mammography," says Dr. Stelling.

A combination of mammograms, clinical breast exams, and breast self-exams is the recommended approach for complete breast care. According to the American Cancer Society, women should begin monthly breast self-exams at the age of 20, with a breast exam by a health care professional every 3 years until the age of 39. Beginning at the age of 40, women should not only begin yearly mammography but also yearly breast exams by a health care professional while continuing to perform monthly breast self-exams.

"The main exception to this is women whose mothers or sisters had premenopausal breast cancer - they should consult their personal physicians about beginning mammography before the age of 40, usually in their mid-30s," says Dr. Stelling. Women with breast problems should ask their physicians about receiving a diagnostic, rather than a screening, mammogram.

By detecting breast cancer in its early stages, patients not only have a better long-term prognosis but also a better chance for conserving their breasts, says Dr. Stelling.

"Technology has changed in the last 10 years for diagnosis of breast cancer," says Dr. Antoinette Ripepi, clinical assistant professor of surgery at Baylor College of Medicine and a member of the surgical staff at The Methodist Hospital. "We are now doing more minimally invasive procedures such as stereotactic biopsies and the ABBI technique which require less surgery to obtain a diagnosis."

Once a woman is told she has breast cancer, the battle begins. And it is a battle that can be won.

"Women who are newly diagnosed with breast cancer need to realize that there are breast cancer survivors and the majority of patients are survivors," says Dr. Ripepi. "It is possible to resume all their usual activity and their lifestyles can be near normal after treatment."

In fact, according to the American Cancer Society, the five-year survival rate for localized breast cancer is 97 percent, compared to 72 percent in the 1940s. Sixty-five percent survive 10 years and 56 percent survive 15 years.

Depending on the size and location of the breast cancer, treatment options may involve conservative breast surgery or modified radical mastectomy. Conservative breast surgery retains the breast in terms of appearance and is supplemented with radiation therapy. Modified radical mastectomy, where the breast is removed with the cancer, has been "the gold standard for years and is still used in many cases depending on the type of cancer and the patient's choice," says Dr. Ripepi.

Other technological advances for breast cancer lie in the field of genetics with research into the BRCA1 and BRCA2 genes.

"Breast cancer genetics is a very active field," says Dr. Ripepi. "However, we have not yet learned how and when to apply genetic testing to the vast majority of patients."

With the television show Murphy Brown devoting its last season to the topic of breast cancer and the new magazine MAMM surfacing as a source of information for women with the disease, more women seem to be coming forward with their stories, sharing their fears and frustrations, talking about their disease.

"Twenty years ago, women would not talk about the disease. Women would not say 'I'm going for a mammogram,'" says Dr. Stelling. "Now women team up and go as buddies. They turn their nervous energy into action."

A former first lady. A childhood star. An award-winning journalist. All survivors.

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©2006 Texas Medical Center

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