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Prisma Health On Call: Your breast cancer questions, answered

You asked, Prisma Health oncologists and radiologists answered.

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October is Breast Cancer Awareness Month for good reason — mammograms + increased knowledge saves lives.

Photo provided by Prisma Health

Table of Contents

While October might catch you saying phrases like “autumn leaves and pumpkins, please,” there’s another set of words you’ll hear this month: mammograms, prevention, and early detection.

That’s right, October is Breast Cancer Awareness Month. Just in time for the annual reminder to be proactive about your breast health, we asked readers to send us their breast cancer questions — and Prisma Health oncologists and radiologists are back with answers to your questions about cancer risks, myths, the BRCA gene, mammogram age guidance, and so much more.

Are there any signs of breast cancer other than lumps?

Some other signs of breast cancer can include overlying skin changes, nipple discharge, lumps in the underarm, and a change in the shape of the nipple. It’s best to be familiar with what your breasts normally feel like so that any changes are noticed and prompt an evaluation by your physician. Find out what breast changes are normal.

Does avoiding sugar help slow down cancer cell turnover or is that just a myth?

Minimizing sugar, whether you are being treated for cancer or any other time, is important for overall health and maintaining a normal weight. See how nutrition may prevent cancer.

What factors put you at higher risk for breast cancer?

Just being a woman increases a person’s risk for breast cancer, but there are several other factors, including family history, age, having dense breasts, obesity, and some forms of hormone replacement therapy. Find out what you can do to lower your risk.

How do you recommend dealing with the mental health struggles associated with being diagnosed with and treated for breast cancer?

Our social workers and breast cancer nurse navigators actively support and have resources to help women cope throughout their cancer journey. Get some cancer coping tips and learn more about our support and survivorship resources.

At what age should you start getting mammograms?

Annual screening mammograms are recommended beginning at age 40 for women at average risk for breast cancer, and earlier if there are risk factors. In addition to detecting breast cancer early, mammograms can determine whether a woman has dense breasts, which is an important risk factor for breast cancer.

Is a 3D mammogram any better at detecting breast cancer than a regular mammogram?

Yes, a 3D mammogram is superior, especially for women with dense breast tissue, because it provides multiple images, allowing the radiologist to evaluate your breast tissue layer by layer. Many studies have shown 3D is superior to 2D since the FDA approved 3D mammography in 2011. Most recently, it was found to provide increased cancer detection and fewer false positives.

What are my preventative treatment options if I am at high risk for developing breast cancer due to family history (mother or sister with breast cancer), personal health history, and density of breast tissue?

If you’re at high risk of developing breast cancer, talk to your primary care doctor about a referral to a high-risk breast cancer program for a risk assessment. The risk assessment determines any preventive measures you can take based on your medical history.

I have been told that I have “dense breast tissue,” and that, therefore, breast cancer is more difficult to detect via mammogram. Is thermography a reasonable alternative to mammography, or can it be a good supplement to my mammogram?

Thermography is not a proven screening tool. However, 3D mammography is recommended for women with dense breast tissue. Women who have a family history of breast cancer and dense breasts should discuss the role of breast MRI and breast ultrasound with their physician.

How should patients with family history go about genetic testing (BRCA) when it is so cost prohibitive?

Those with a family history of the BRCA gene can be referred for genetic counseling and testing. If there is a proven BRCA mutation in the family, the genetic testing is indicated by NCCN guidelines and usually covered by insurance. Learn more about genetic counseling cost and who should be tested.

Do I need to do self breast exams?

Research has shown that self breast exams are not adequate for primary screening as they’re not effective in detecting cancer or increasing survival rates. However, doctors teach self breast techniques so that patients understand what is normal and can identify changes that may not be normal for further evaluation.

I am 78 years old. Do I still need to get a mammogram?

It depends on whether you have high-risk factors such as dense breasts, family history, or a genetic mutation (inherited trait), or even a previous history of cancer. If a 78-year-old is at average risk, the next discussion is about overall general health and life expectancy. It is generally accepted to continue screening if your life expectancy is 10 years or more.

How is a mammogram performed?

You will stand in front of a mammography X-ray machine and a mammography technologist will place your breast on a plate. Another plate will firmly press your breast from above. The plates will flatten the breast, holding it still while the X-ray is being taken. You will feel some pressure, but the exam is over quickly. To produce the best pictures possible, it is important to stay still during the examination. Each breast is imaged in two different projections by changing the angle.

Are you due for a mammogram? Schedule a screening mammogram at Prisma Health (no physician referral required).

A big thanks to Nirupama Anne, MD, Surgical Oncology; Rajshri Nayakwadi Shah, MD, Diagnostic Radiology; LeAnn Perkins, FNP, Integrative Oncology and Lifestyle Medicine for their knowledge + expertise.