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Breast cancer detection

Breast cancer is the number one diagnosed cancer in women in the United States. And although there are known risks that make certain women at higher risk for developing the disease (such as a family history), 75 percent of women who are diagnosed with breast cancer have no known risk factors.

Know your own body
Your first line of defense is to do a monthly breast self-examination (BSE). In fact, 55 percent of cancers can be found by the woman herself. A lifetime of self-examination will alert you to even the most subtle changes, all of which should be reported to your doctor.

The importance of a clinical exam
As knowledgeable as you can become about your own breasts, a doctor or nurse has the advantage of having performed hundreds of clinical exams on different women with a number of special concerns, such as fibrocystic breasts, and can often distinguish between a lump that is benign and one that needs a closer look. A trained healthcare professional can find 65 to 75 percent of cancers during a clinical exam.

The American Cancer Society advises that women should have a clinical breast exam once a year, beginning at age 40. The exam is usually performed at the same time as a gynecological exam or Pap smear and/or a mammogram.

Regular mammograms are a woman's best friend
Mammograms, low-dose X-rays of the breast, can detect up to 85 percent of cancers, some of which are too small to be felt, and some of which are actually in a precancerous stage. Digital mammography, computerized images that can detect cancers with greater accuracy than traditional X-ray mammography, is the next big step in breast cancer screening and should be widely available within the next several years.

The great divide
There is controversy over whether women in their 40s should receive mammograms annually or every couple of years. Part of the reason for the disagreement is that some studies have shown no survival benefit to getting annual mammograms before age 50. Also, there is a higher rate of false positives (lumps that are biopsied but found to be benign) in women under 50. Ultimately, it's up to you and your doctor to decide, depending on your risk factors, how often you should get mammograms in your 40s.

The consensus
All experts agree that after age 50, annual mammograms save lives. Seventy-five percent of all cancers are found in women age 50 and over, partly because the cancers have developed to detectable sizes and partly because mammograms are more accurate when done on older women, whose breast tissue is more fatty and produces clearer mammograms.

New help for dense breasts
Combining a mammogram with an ultrasound test increased breast cancer detection from 70 percent to 94 percent in women with very dense breast tissue. Ultrasound, which uses high-frequency sound waves, is sometimes used as a follow-up when a mammogram reveals something suspicious.

What are the risk factors?
Being a woman is the primary risk factor for breast cancer (although men can get it too). The following are other key risk factors:

  • You have a family history of breast cancer.
  • You are over the age of 50.
  • You had your first child after age 30 or have never had children.
  • You began menstruating before age 12.
  • You began menopause after age 55.
  • You eat a diet high in fat.
  • You smoke.
  • You abuse alcohol.
  • You don't exercise.
  • You have been exposed to environmental dangers such as pesticides.

Baptist Health Louisville offers mammography services through its Women's Imaging Services, located in the hospital. For more information about mammography services, call the Baptist Health Information Center at (502) 897-8131.