Knowledge is power when it comes to pre venting and treating breast cancer … early detection saves lives.
BY RACHEL DULTZ, M.D. Princeton HealthCare System
They are mothers and sisters, aunts and cousins. They are friends and neighbors, co-workers and peers. They are professionals and retirees, rich and poor, from every race and ethnic background. They are the more than 2.5 million women in the United States today who have survived breast cancer.
October is Breast Cancer Awareness Month and a time to remind women about the importance of cancer prevention and early detection when it comes to addressing breast health.
In 2008 alone, an estimated 200,000 women will be diagnosed with breast cancer, which is the leading cause of new cancer diagnoses after skin cancer, according to the American Cancer Society. Moreover, the disease is the second leading cause of death among women after lung cancer.
Most breast cancers arise with no known cause. Just being a woman means you are at risk for the disease, and that risk increases as you age. In fact, women over 70 years old have a 25 percent chance of developing breast cancer.
But in addition to increasing age and being female, there are several other factors that increase a woman’s risk for breast cancer, including:
• Early age at the onset of menstruation;
• Late age for menopause;
• Never having children or having children later in age;
• Previous incidence of certain benign breast conditions, such as benign lesions;
• Obesity;
• Smoking;
• Alcohol consumption;
• Family and personal history, and
• Genetics.
While there is no sure way to prevent breast cancer, women can reduce their risks by avoiding alcohol and cigarettes, exercising regularly and maintaining a healthy body weight.
Most important, with early detection, breast cancer can be stopped and treated. In fact, research shows that mortality rates are declining by about 2 percent each year in large part because of early detection and treatment.
The society recommends the following guidelines for breast cancer screening:
• Starting at age 40 women should have an annual mammogram to screen for abnormalities or changes in the breasts from year to year.
• Women with a family history of breast cancer should begin going for regular mammograms starting at age 30.
• Women between the ages of 20 and 39 should have a clinical breast exam by a physician or nurse practitioner every three years and perform breast self-exams monthly.
A mammogram is an X-ray of the breast and is quick and virtually painless. Women may experience a slight discomfort, but it only lasts a few seconds before the screening is complete. When determining where to go for a mammogram, women should turn to a reputable, certified, state-of-the art center such as the University Medical Center at Princeton Breast Health Center, where the primary focus is on women and breast health.
At the Breast Health Center, women are typically able to receive the results of their mammograms within 24 hours, helping to minimize the anxiety they may feel about the test. It is important for women to remember that nearly 80 percent of abnormalities on mammograms are not cancer.
University Medical Center at Princeton also offers a MammoRemindHer service, which sends women an annual e-mail reminder to schedule their mammogram and monthly e-mail reminders to perform breast self-exams. Signing up for this life-saving service is easy and can be done quickly by visiting www.mammoremindher.org.
In addition to mammograms, women with a family history of breast cancer might also consider genetic counseling and testing to help determine their risk for the disease. Approximately 5 percent of breast cancer cases are hereditary and linked to a mutation in the BRCA 1 and BRCA 2 genes. Genetic testing helps identify these mutations, which increase the risk for the disease significantly. According to the National Cancer Institute, women with an altered BRCA gene are 3 to 7 times more likely to develop breast cancer than women without alterations in those genes.
Candidates for genetic testing include women in families where there have been multiple cases of pre-menopausal breast cancer; women with family members who have had breast and ovarian cancer; and women of Ashkenazi Jewish descent. These women specifically have been found to have a significantly higher chance of having the altered BRCA gene than the general population.
With genetic counseling, women can plan a course of action with their health care providers should the screening identify a mutation of the BRCA gene. Options range from increased surveillance and screening to chemotherapy drugs such as Evista and Tamoxifen that have been proven to help reduce the risk of developing breast cancer. For women at very high risk, prophylactic surgery (a double mastectomy) with immediate breast reconstruction may be another option. Removing the ovaries may also reduce the risk of breast cancer in younger women. Prophylactic surgery for high-risk patients is typically covered by insurance companies and is 95 percent effective in preventing the development of future cancer.
Women who are considering genetic testing should speak with their physician about their risk factors. Genetic counseling will provide information about the implications of testing and how the results impact future medical care. Childbirth is a major factor as many women may not yet have had children and may be concerned about passing on the gene.
Knowledge is power when it comes to preventing and treating breast cancer, and with Breast Cancer Awareness Month upon us, women across the nation are reminded that early detection saves lives.
In celebration of Breast Cancer Awareness Month, Princeton HealthCare System through its Community Education & Outreach Program will host a discussion titled “Breast Health: What Women Need to Know” on Wednesday, Oct. 1, between 7 and 8:30 p.m. at the UMCP Breast Health Center, 300 Princeton-Hightstown Road, East Windsor Medical Commons 2, East Windsor. The discussion is part of the Meredith Maher Peterson Lecture Series.
To register for the free session or for more information visit www.princetonhcs.org/calendar or call 888-897-8979.
Dr. Rachel P. Dultz is a board-certified surgeon and medical director of the University Medical Center at Princeton’s Breast Health Center.
Teen self-help resource
Princeton Public Library hosts an extensive electronic reference center with access to the teen-specific database Teen Health and Wellness: Real Life, Real Answers. This research database and self-help resource is a fully interactive online community center focusing on the medical health and emotional needs of teens.
The Teen Health and Wellness Database provides students with comprehensive curricular support and self-help tools on topics including diseases, drugs, alcohol, nutrition, fitness, mental health, diversity, family life and more.
Information is presented using a sensitive, respectful and age-appropriate approach and gives insight into the teen experience. Regularly updated homepage content connects timely medical news and social issues to database articles, and a resource section lists relevant Web sites, organizations and further recommended reading.
Susan Conlon, the library’s teen services librarian, believes Teen Health and Wellness is a powerful information source for teens on complex and sensitive issues they face in middle and high school.
Created by Rosen Publishing and named one of the 10 best online resources of 2007 by Library Journal, the database features authentic first-person teen narratives, interactive polls and quizzes and national 24-hour hotlines for teens in crisis. Its comprehensive articles about teen health and well-being have been reviewed by leading professionals.
The Teen Health and Wellness Database is supported by a grant from the Horizon Foundation, Inc.
On the Web: www.teenhealthandwellness.com.

