Sylvester Comprehensive Cancer Center

Prevention and Screening: Breast Cancer

Mammogram of the breast indicating a cancerous lump

Mammogram of the breast indicating a cancerous lump Photograph used by permission of the National Cancer Institute

Risk Factors for Breast Cancer

Call 305-243-5512 in Miami, 954-571-0152 in Deerfield Beach or toll free 866-584-1942 today to make an appointment for a mammogram with a breast health specialist at Sylvester. You can schedule your annual mammogram at one of our convenient locations in Miami or Deerfield Beach.

Anything that may increase a person’s chance of developing a disease is called a risk factor. Simply being a woman puts one at risk for breast cancer, however most women who have one or more breast cancer risk factors never develop the disease, while many women with breast cancer have no apparent risk factors (other than being a woman and growing older). Factors associated with an increased risk of breast cancer include:

  • Age 50 or over
  • A personal or family history of breast cancer
  • Exposure of the breast or chest to radiation
  • Changes in certain genes, especially the BRCA1 and BRCA2 genes
  • Dense breast tissue
  • Menstrual periods that began early in life (before age 12) or menopause that began later in life (after age 55)
  • Alcohol use (2 to 5 drinks daily)
  • Not having children or having a first child after age 30
  • Physical inactivity
  • Recent use of oral contraceptives
  • Long-term use of hormone replacement therapy (HRT)
  • Weight gain and obesity, especially after menopause

Breast Cancer Screening

As a designated Breast Imaging Center of Excellence, the Braman Family Breast Cancer Institute at Sylvester follows the recommendations of the American Cancer Society, the American College of Radiology and the Society of Breast Imaging, which recommend that women should begin annual mammograms at age 40. In addition, a clinical breast exam should be part of a periodic health exam every year for women 40 and older, and every three years for women in their 20s and 30s. Women at high risk for breast cancer should also have an annual MRI.

Women whose mother or sister developed breast cancer before menopause may begin yearly screening when they are 10 years younger than the age at which their relative was diagnosed.

The decision to continue mammograms after age 75 should be evaluated by each patient in consultation with her physician, taking into consideration the patient’s overall state of health, current life expectancy, and quality of life issues.

The Braman Insititute issued a statement in response to the questions and concerns about breast cancer screening raised by the U.S. Preventive Services Task Force (USPSTF) in the Annals of Internal Medicine on Nov. 16, 2009.

Read the full statement and Braman Family Breast Cancer Institute Breast Cancer Screening Recommendation »

Mammography

Mammography is a vital step toward breast cancer detection that saves lives. A mammogram is an X-ray of the breast taken by positioning a woman’s breasts between two plates. This procedure helps detect and diagnose early breast disease.

There are two types of mammograms:

  • Screening Mammogram – To detect breast changes in women who have no signs of breast cancer, a screening mammogram can be used. It usually involves two X-rays of each breast but can include four views of each breast, especially in women who have breast implants.
  • Diagnostic Mammogram – An X-ray of the breast used to diagnose unusual breast changes is called a diagnostic mammogram. These changes may include a lump, pain, nipple thickening, or discharge, or a change in breast size or shape. In addition to the regular views performed on a screening mammogram, additional specialized views may be required.
  • 2 D or routine Mammogram vs Tomosynthesis: a 2 D mammogram takes 2 images of each breast. The 3D mammogram or Tomosynthesis takes multiple thin x-rays throughout the breast which may help detect cancer more easily by helping to differentiate normal breast tissue from abnormal findings. For more information about Tomosynthesis, visit http://www.hologic3d.com/

The Braman Family Breast Cancer Institute at Sylvester and the American Cancer Society recommend that women 40 and older have a yearly mammogram and continue to do so throughout their lives, while they are in good health. Our UHealth Imaging team uses the latest technology and specialized breast cancer expertise according to your specific risk factors to detect abnormalities and accurately diagnose breast cancer at the earliest stage — when it’s most treatable.

Call 305-243-5512 in Miami, 954-571-0152 in Deerfield Beach or toll free 866-584-1942 today to make an appointment for a mammogram with a breast health specialist at Sylvester. You can schedule your annual mammogram at one of our convenient locations in Miami or Deerfield Beach.

Breast Self Examination

By performing a breast self examination every month, you will get to know how your breasts normally feel so that you are more likely to detect changes. Ask your doctor to show you how to do a breast self-exam to check for any lumps or other changes in your breasts. Though breast self-exams alone cannot accurately determine the presence of breast cancer, this technique should be used in addition to mammography and a clinical breast exam by a doctor.

Check with your doctor if you notice a concerning change in your breasts, such as:

  • Development of a lump
  • Discharge other than breast milk
  • Swelling of the breast
  • Skin irritation or dimpling
  • Nipple abnormalities (such as pain, redness, scaliness, or nipples turning inward)

Hereditary Breast Cancer

In recent years, certain gene mutations have been found to be associated with an inherited increased risk for breast cancer. These genes normally work to help the body prevent cancer, particularly in the breasts. If a person is born with a mutation in only one copy of one of these genes, he/she is more likely to develop breast cancer.

Hereditary factors account for 5 to10 percent of newly diagnosed female breast cancer cases in the U.S. each year. Inherited alterations in the BRCA1 and BRCA2 genes are involved in many cases of hereditary breast and ovarian cancers, according to the National Cancer Institute (NCI).

While the lifetime risk of developing breast cancer for a woman in the general population is approximately 12 percent (or one in eight), the risk is at least five times higher for a woman with an altered BRCA1 or BRCA2 gene, according to the NCI. The lifetime risk for women who have a family history of breast cancer, but no known genetic mutation is 20-30 percent, while the risk for women with a genetic mutation inherited from either parent is even higher: 60-80 percent.

Women with these altered genes are also more likely to develop breast cancer at a younger age and are at higher risk of recurrence if they have had breast cancer. They are also more likely to have multiple close family members with the disease. Men with an altered BRCA1 or BRCA2 gene have an increased risk for developing breast cancer, and possibly, prostate cancer compared to men without the altered genes.

These gene mutations are more common in certain populations, including those with:

  • Ashkenazi Jewish ancestry (Central or Eastern European)
  • Norwegian, Dutch or Icelandic ancestry
  • Extensive family histories of breast and ovarian cancer
  • Breast cancer diagnosed before the age of 50
  • Bilateral breast cancer
  • Breast and ovarian cancer diagnosed in the same person
  • Male breast cancer

Genetic Counseling and Testing

The Braman Family Breast Cancer Institute at Sylvester offers genetic counseling and testing for genetic mutations related to breast cancer. A genetics counselor is on staff and genetic counseling is offered based on factors such as significant family history or young age at first diagnosis of breast cancer. The Center for Cancer Prevention and Genetics provides this service.

Testing for genetic mutations related to breast cancer makes it possible to identify individuals who have an inherited increased risk of breast and ovarian cancer. Treatment options for those with inherited increased risk include screening and preventive strategies.

To learn more or to schedule an appointment, call Talia Donenberg, M.S., CGC, genetic counselor at 305-243-3627.

Preventative Hormonal Therapy

Certain drugs, such as tamoxifen (Nolvadex®) and raloxifene (Evista®), have been shown to prevent breast cancer in some women who are at higher risk for the disease. Women who are concerned that they may be at an increased risk of developing breast cancer should talk with their doctor about whether to take one of these preventative hormonal therapy drugs, schedule more frequent or thorough breast screenings, or pursue other preventative procedures, such as prophylactic surgery (surgical removal of the breasts and/or ovaries to reduce the risk of breast cancer).

Sources: Greystone.net, American Cancer Society, and National Cancer Institute